Renoprotective effects of febuxostat compared with allopurinol in patients with hyperuricemia: A systematic review and meta-analysis

Sollip Kim, Hyun Jung Kim, Hyeong Sik Ahn, Se Won Oh, Kum Hyun Han, Tae Hyun Um, Chong Rae Cho, Sang Youb Han

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Hyperuricemia is reported to be related to rapid progression of renal function in patients with chronic kidney disease (CKD). Allopurinol, a uric acid lowering agent, protects renal progression. However, it is not widely used in patients with CKD because of its serious adverse event. Febuxostat can be alternatively used for patients who are intolerable to allopurinol. We aimed to determine renoprotective effect and urate-lowering effect between the two drugs. Methods: We performed a systematic review and meta-analysis of randomized controlled trials to assess the effects of febuxostat compared to allopurinol in patients with hyperuricemia. MEDLINE, Embase, and Cochrane Library databases were searched to identify research publications. Results: Four relevant publications were selected from among 3,815 studies. No significant differences were found in the changes in serum creatinine from baseline between the febuxostat and allopurinol groups. Changes in estimated glomerular filtration rate (eGFR) were observed between the two groups at 1 month (mean difference 1.65 mL/ min/1.73 m2, 95% confidence interval [CI] 0.38, 2.91 mL/min/1.73 m2; heterogeneity χ2 = 1.25, I2 = 0%, P = 0.01); however, the changes in eGFR were not significantly different at 3 months. A significant difference did exist in the changes in albuminuria levels from baseline between the febuxostat and allopurinol groups (mean difference -80.47 mg/gCr, 95% CI -149.29, -11.64 mg/gCr; heterogeneity χ2 = 0.81, I2 = 0%, P = 0.02). A significant difference was also observed in the changes in serum uric acid from baseline between the febuxostat and allopurinol groups (mean difference -0.92 mg/dL, 95% CI -1.29, -0.56 mg/dL; heterogeneity χ2 = 6.24, I2 = 52%, P < 0.001). Conclusion: Febuxostat might be more renoprotective than allopurinol.

Original languageEnglish
Pages (from-to)274-281
Number of pages8
JournalKidney Research and Clinical Practice
Volume36
Issue number3
DOIs
Publication statusPublished - 2017 Sep 1

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Hyperuricemia
Allopurinol
Meta-Analysis
Uric Acid
Confidence Intervals
Glomerular Filtration Rate
Chronic Renal Insufficiency
Publications
Renal Agents
Albuminuria
Febuxostat
Serum
MEDLINE
Libraries
Creatinine
Randomized Controlled Trials
Databases
Kidney
Research
Pharmaceutical Preparations

Keywords

  • Chronic kidney disease
  • Febuxostat
  • Gout
  • Hyperuricemia
  • Meta-analysis

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

Renoprotective effects of febuxostat compared with allopurinol in patients with hyperuricemia : A systematic review and meta-analysis. / Kim, Sollip; Kim, Hyun Jung; Ahn, Hyeong Sik; Oh, Se Won; Han, Kum Hyun; Um, Tae Hyun; Cho, Chong Rae; Han, Sang Youb.

In: Kidney Research and Clinical Practice, Vol. 36, No. 3, 01.09.2017, p. 274-281.

Research output: Contribution to journalArticle

Kim, Sollip ; Kim, Hyun Jung ; Ahn, Hyeong Sik ; Oh, Se Won ; Han, Kum Hyun ; Um, Tae Hyun ; Cho, Chong Rae ; Han, Sang Youb. / Renoprotective effects of febuxostat compared with allopurinol in patients with hyperuricemia : A systematic review and meta-analysis. In: Kidney Research and Clinical Practice. 2017 ; Vol. 36, No. 3. pp. 274-281.
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AU - Kim, Hyun Jung

AU - Ahn, Hyeong Sik

AU - Oh, Se Won

AU - Han, Kum Hyun

AU - Um, Tae Hyun

AU - Cho, Chong Rae

AU - Han, Sang Youb

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N2 - Background: Hyperuricemia is reported to be related to rapid progression of renal function in patients with chronic kidney disease (CKD). Allopurinol, a uric acid lowering agent, protects renal progression. However, it is not widely used in patients with CKD because of its serious adverse event. Febuxostat can be alternatively used for patients who are intolerable to allopurinol. We aimed to determine renoprotective effect and urate-lowering effect between the two drugs. Methods: We performed a systematic review and meta-analysis of randomized controlled trials to assess the effects of febuxostat compared to allopurinol in patients with hyperuricemia. MEDLINE, Embase, and Cochrane Library databases were searched to identify research publications. Results: Four relevant publications were selected from among 3,815 studies. No significant differences were found in the changes in serum creatinine from baseline between the febuxostat and allopurinol groups. Changes in estimated glomerular filtration rate (eGFR) were observed between the two groups at 1 month (mean difference 1.65 mL/ min/1.73 m2, 95% confidence interval [CI] 0.38, 2.91 mL/min/1.73 m2; heterogeneity χ2 = 1.25, I2 = 0%, P = 0.01); however, the changes in eGFR were not significantly different at 3 months. A significant difference did exist in the changes in albuminuria levels from baseline between the febuxostat and allopurinol groups (mean difference -80.47 mg/gCr, 95% CI -149.29, -11.64 mg/gCr; heterogeneity χ2 = 0.81, I2 = 0%, P = 0.02). A significant difference was also observed in the changes in serum uric acid from baseline between the febuxostat and allopurinol groups (mean difference -0.92 mg/dL, 95% CI -1.29, -0.56 mg/dL; heterogeneity χ2 = 6.24, I2 = 52%, P < 0.001). Conclusion: Febuxostat might be more renoprotective than allopurinol.

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