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Kidney Week

Abstract: PO2396

Network Meta-Analysis for Prevention of Kidney Function Decline Using Uric-Acid-Lowering Therapy in CKD Patients

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Tsukamoto, Shunichiro, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Wakui, Hiromichi, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Azushima, Kengo, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Yamada, Takayuki, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Urate, Shingo, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Suzuki, Toru, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Abe, Eriko, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Taguchi, Shinya, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Tanaka, Shohei, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • Tamura, Kouichi, Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
Background

Several previous studies have suggested that uric-acid-lowering therapy (ULT) can slow the progression of chronic kidney disease (CKD). However, few studies have evaluated the effects of each ULT treatment on kidney function, although this topic is crucial for CKD patients. This systematic review aimed to summarize evidence from randomized controlled trials (RCTs) concerning the effects of ULT on kidney function.

Methods

We performed a systematic search and selected RCTs in CKD patients comparing the effects of ULT on kidney function. We performed a network meta-analysis to compare each ULT indirectly. The primary outcome was change in estimated glomerular filtration rate (eGFR) from baseline. Treatment effects were summarized using random-effects model.

Results

Ten studies were selected with a total of 1480 patients. Topiroxostat significantly improved eGFR compared to placebo (MD [95% CI]; 1.49 [0.08; 2.90], P = 0.038) (Fig. 1). Although Febuxostat did not show a positive effect overall, it significantly improved renal function (eGFR) in a subgroup analysis of CKD patients with hyperuricemia (MD [95% CI]; 0.85 [0.02; 1.67], P = 0.045) (Fig. 2). Allopurinol and pegloticase did not show good effects.

Conclusion

Topiroxostat and febuxostat have better renoprotective effects in CKD patients. we believe that the results of this study allow us to recommend ULT with topiroxostat or febuxostat for patients with CKD.