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Abstract: SA-PO896

Urate Lowering Drugs for CKD Patients With Asymptomatic Hyperuricemia and Hypertension: A Randomized Trial

Session Information

Category: CKD (Non-Dialysis)

  • 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

  • Kohagura, Kentaro, Ryukyu Daigaku Igakubu Fuzoku Byoin, Nakagami-gun, Okinawa, Japan
  • Satoh, Atsushi, Fukuoka Daigaku Igakubu Daigakuin Igaku Kenkyuka, Fukuoka, Fukuoka, Japan
  • Kochi, Masako, Tomishiro Chuo Byoin, Tomishiro, Okinawa, Japan
  • Kinjo, Kazushi, Nakagami Byoin, Okinawa, Okinawa, Japan
  • Yamazato, Masanobu, Ryukyu Daigaku Igakubu Daigakuin Igaku Kenkyuka, Nakagami-gun, Okinawa, Japan
  • Ishida, Akio, Ryukyu Daigaku Igakubu Daigakuin Igaku Kenkyuka, Nakagami-gun, Okinawa, Japan
  • Sakima, Atsushi, Ryukyu Daigaku Igakubu Daigakuin Igaku Kenkyuka, Nakagami-gun, Okinawa, Japan
  • Iseki, Kunitoshi, Nakamura clinic, Urasoe, Japan
  • Arima, Hisatomi, Fukuoka Daigaku Igakubu Daigakuin Igaku Kenkyuka, Fukuoka, Fukuoka, Japan
  • Ohya, Yusuke, Ryukyu Daigaku Igakubu Daigakuin Igaku Kenkyuka, Nakagami-gun, Okinawa, Japan

Group or Team Name

  • URIC CKD study group
Background

Xanthine oxidase (XO) inhibitors may retard the progression of chronic kidney disease (CKD). It is unknown whether a different type of urate-lowering therapy is comparably effective for it. To determine urate-lowering therapy with XO inhibitor and urate transporter 1 inhibitor are comparable for slowing the decline in renal function among CKD patients with hypertension and hyperuricemia.

Methods

Open-label, randomized, parallel-group clinical trial in 96 patients with stage 3 CKD from 9 facilities in Okinawa, Japan. Eligible patients had hyperuricemia without a history of gout, and hypertension. Patients were randomized to receive either febuxostat (n = 47) or benzbromarone (n = 48) and titrated to achieve serum urate levels less than 6.0mg/dL. The primary endpoint was changed in the estimated glomerular filtration rate (eGFR) from baseline to 52 weeks. Secondary endpoints included percent change in uric acid, blood pressure, urinary albumin to creatinine ratio, and XO activity from the baseline to 8 and 52 weeks.

Results

Among 95 randomized patients, 88 (92.6%) completed the trial. There was no significant difference in change in eGFR (mL/min/1.73 m2) between the febuxostat (-0.23, 95% CI, −2.00 to 1.55) and benzbromarone (−2.18, 95% CI, −3.84 to −0.52) groups (difference, 1.95; 95% CI, −0.48 to 4.38; P = 0.1), and in secondary endpoints except for XO activity. Febuxostat significantly reduced XO activity. There were no significant differences in the effects of febuxostat compared with benzbromarone on primary outcomes in the whole analysis, although subgroup analysis demonstrated a significant benefit from febuxostat in patients with stage 3a CKD. There were no adverse effects specific to either drug.

Conclusion

There was no clear difference between febuxostat and benzbromarone in inhibiting the decline in renal function among stage 3 CKD patients with hyperuricemia and hypertension.

Funding

  • Commercial Support