Uric acid lowering for slowing CKD progression after the CKD-FIX trial: a solved question or still a dilemma? | Zendy

Giovanna Leoncini | Zendy; Cecilia Barnini | Zendy; Luca Manco | Zendy; Alessandro Nobili | Zendy; Daniele Dotta | Zendy; Martina Penso | Zendy; Elisa Russo | Zendy; Francesca Cappadona | Zendy; Francesca Viazzi | Zendy; Roberto Pontremoli | Zendy

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Uric acid lowering for slowing CKD progression after the CKD-FIX trial: a solved question or still a dilemma?

Author(s) -

Giovanna Leoncini,

Cecilia Barnini,

Luca Manco,

Alessandro Nobili,

Daniele Dotta,

Martina Penso,

Elisa Russo,

Francesca Cappadona,

Francesca Viazzi,

Roberto Pontremoli

Publication year - 2022

Publication title -

clinical kidney journal

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.033

H-Index - 40

eISSN - 2048-8513

pISSN - 2048-8505

DOI - 10.1093/ckj/sfac075

Subject(s) - febuxostat , medicine , hyperuricemia , uric acid , gout , allopurinol , xanthine oxidase inhibitor , kidney disease , intensive care medicine , randomized controlled trial , xanthine oxidase , disease , clinical trial , bioinformatics , biochemistry , chemistry , biology , enzyme

Hyperuricemia has been associated with several cardiovascular risk factors and is a well-known predictor of kidney disease. In vitro studies as well as animal models highlighted a role for uric acid in the development and progression of haemodynamic and tissue damage at the renal level leading to glomerular and tubulointerstitial abnormalities. Urate-lowering treatment, especially by xanthine oxidase inhibitors, has been proposed in order to improve kidney outcomes. However, recent randomized controlled trials failed to demonstrate a beneficial effect of allopurinol or febuxostat on renal disease, casting doubts on the role of this therapeutical approach to improve nephroprotection. We provide a critical overview of current literature on this topic and offer a possible interpretation of results from recent intervention trials with urate-lowering treatment on renal outcomes.

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