Allopurinol May Slow Kidney Disease Progression

In this small study, allupurinol was associated with a significant 68% decreased risk of renal events, such as initiation of dialysis.
In this small study, allupurinol was associated with a significant 68% decreased risk of renal events, such as initiation of dialysis.

Long-term treatment with allopurinol may slow the rate of progression of kidney disease and decrease cardiovascular (CV) risks, according to a new study published online ahead of print in the American Journal of Kidney Diseases.

The study, which was a post-hoc analysis of long-term follow-up of a 2-year randomized controlled trial of allopurinol, included 113 participants with an estimated glomerular filtration rate below 60 mL/min/1.73 m2. Of these, 57 received treatment with allopurinol and 56 continued on their standard treatment (controls).

During a median follow-up of 84 months, 9 patients in the allopurinol group had a renal event compared with 24 patients in the control arm, a difference that translated into a significant 68% decreased risk in adjusted analyses. In addition, 16 patients in the allopurinol group experienced CV events compared with 23 in the control arm, which translated into a significant 57% decreased risk.

The investigators, led by Marian Goicoechea, MD, PhD, of Hospital General Universitario Gregorio Marañón in Madrid, Spain, defined a renal event as initiation of dialysis, and/or a doubling of serum creatinine, and/or a 50% or greater decrease in estimated glomerular filtration rate. They defined CV events as myocardial infarction, coronary revascularization or angina pectoris, congestive heart failure, cerebrovascular disease, or peripheral vascular disease.

The authors acknowledged some study limitations, including a relatively small sample size and absence of a double-blind design.

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