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 language | English |
|---|---|
| Pages (from-to) | 274-281 |
| Number of pages | 8 |
| Journal | Kidney Research and Clinical Practice |
| Volume | 36 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2017 Sep 1 |
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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 journal › Article
}
TY - JOUR
T1 - Renoprotective effects of febuxostat compared with allopurinol in patients with hyperuricemia
T2 - A systematic review and meta-analysis
AU - Kim, Sollip
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
PY - 2017/9/1
Y1 - 2017/9/1
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.
AB - 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.
KW - Chronic kidney disease
KW - Febuxostat
KW - Gout
KW - Hyperuricemia
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85034858752&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034858752&partnerID=8YFLogxK
U2 - 10.23876/j.krcp.2017.36.3.274
DO - 10.23876/j.krcp.2017.36.3.274
M3 - Article
AN - SCOPUS:85034858752
VL - 36
SP - 274
EP - 281
JO - Kidney Research and Clinical Practice
JF - Kidney Research and Clinical Practice
SN - 2211-9132
IS - 3
ER -