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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Kidney+Res+Clin+Pract
2017 ; 36
(3
): 274-281
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Renoprotective effects of febuxostat compared with allopurinol in patients with
hyperuricemia: A systematic review and meta-analysis
#MMPMID28904879
Kim S
; Kim HJ
; Ahn HS
; Oh SW
; Han KH
; Um TH
; Cho CR
; Han SY
Kidney Res Clin Pract
2017[Sep]; 36
(3
): 274-281
PMID28904879
show ga
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
m(2), 95% confidence interval [CI] 0.38, 2.91 mL/min/1.73 m(2); heterogeneity
?(2) = 1.25, I(2) = 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 ?(2) = 0.81, I(2) = 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 ?(2) = 6.24, I(2) = 52%, P < 0.001). CONCLUSION:
Febuxostat might be more renoprotective than allopurinol.
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