Efficacy and Safety of Allopurinol on Chronic Kidney Disease Progression: A Systematic Review and Meta-Analysis.

Q2 Medicine

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI:10.5863/1551-6776-29.4.359

Fatemeh Ghane Sharbaf, Elham Bakhtiari, Toktam Faghihi, Farahnak Assadi

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引用次数: 0

Abstract

Objective: Hyperuricemia is associated with the progression of chronic kidney disease (CKD). Whether urate-lowering treatment with allopurinol can delay disease progression remains controversial.

Methods: Relevant databases were searched. Randomized clinical trials comparing the efficacy and -safety of allopurinol in patients with CKD were selected. The primary outcomes were changes in serum uric acid concentration and estimated glomerular filtration rate (eGFR). Random-effects modeling was used to -calculate the standard mean difference (SMD) with 95% CIs.

Results: Four trials enrolling 698 participants were included. All were 2-arm parallel trials with a mean duration follow-up of 22.5 months. Congenital anomalies of the kidney and urinary tract were the most common cause of CKD in children, whereas diabetes was the leading cause of CKD in adults. Allopurinol significantly increased the eGFR compared with control groups (SMD, 2.04; 95% CI, 0.60-3.49; p = 0.005; I² = 98.23%). Allopurinol led to a significant decrease in serum uric acid concentration compared with the control group (SMD, -5.16; 95% CI, -8.31 to -2.01; p = 0.001; I² = 98.80%). No significant difference in adverse effects was identified between treatment and control groups.

Conclusions: Allopurinol treatment in patients with CKD and hyperuricemia slows the decline in eGFR as compared with placebo, without risk of increased adverse effects.

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别嘌醇对慢性肾病进展的疗效和安全性：系统回顾与元分析》。

目的：高尿酸血症与慢性肾脏病（CKD）的进展有关。使用别嘌醇进行降尿酸治疗能否延缓疾病进展仍存在争议：方法：检索了相关数据库。方法：对相关数据库进行了检索，选择了比较别嘌醇对 CKD 患者疗效和安全性的随机临床试验。主要结果是血清尿酸浓度和估计肾小球滤过率（eGFR）的变化。采用随机效应模型计算标准平均差（SMD）和 95% CIs：结果：共纳入四项试验，698 名参与者。所有试验均为双臂平行试验，平均随访时间为 22.5 个月。先天性肾脏和泌尿道异常是导致儿童慢性肾脏病的最常见原因，而糖尿病则是导致成人慢性肾脏病的主要原因。与对照组相比，别嘌醇能明显增加 eGFR（SMD，2.04；95% CI，0.60-3.49；P = 0.005；I2 = 98.23%）。与对照组相比，别嘌醇可显著降低血清尿酸浓度（SMD，-5.16；95% CI，-8.31 至 -2.01；p = 0.001；I2 = 98.80%）。治疗组和对照组的不良反应无明显差异：结论：与安慰剂相比，别嘌醇治疗慢性肾脏病和高尿酸血症患者可减缓 eGFR 的下降，且无不良反应增加的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

2.40

自引率

0.00%

发文量

期刊介绍： The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.