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.