Febuxostat May Slow Renal Decline in Hyperuricemic CKD Patients

Patients treated with the uric acid-lowering drug were less likely to experience a greater than 10% decline in eGFR than placebo recipients.
Patients treated with the uric acid-lowering drug were less likely to experience a greater than 10% decline in eGFR than placebo recipients.

Febuxostat, which reduces production of uric acid, may slow renal function decline in patients with chronic kidney disease (CKD) and asymptomatic hyperuricemia, according to researchers.

In a prospective, single-center, double-blind study, Dipankar Sircar, MD, of the Institute of Postgraduate Medical Education and Research in Kolkata, India, and colleagues randomly assigned 93 patients with CKD stages 3 and 4 and asymptomatic hyperuricemia to receive 40 mg of febuxostat (45 patients) or placebo (48 patients) once daily for 6 months. Patients were followed up for 6 months to evaluate changes in eGFR. The primary study outcome was the proportion of patients showing a greater than 10% decline in estimated glomerular filtration rate (eGFR) from baseline.

The mean eGFR in the febuxostat group increased non-significantly from 31.5 at baseline to 34.7 mL/min/1.73 m2 at 6 months, whereas the mean eGFR in the placebo arm decreased significantly from 32.6 to 28.2 mL/min/1.73 m2 Dr. Sircar's group reported in the American Journal of Kidney Diseases (2015;66:945-950). The researchers observed a greater than 10% decrease in eGFR from baseline in 17 (38%) of the 45 febuxostat recipients compared with 26 (54%) of the 48 placebo recipients, a significant difference between study arms.

The researchers acknowledged that their study was limited by small numbers of patients and short follow-up. In addition, about 10% of the randomly assigned patients dropped out prior to completion, they noted.

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