ArticleThe Permanente journal2018
Urate-Lowering Therapy in Moderate to Severe Chronic Kidney Disease.
Article in The Permanente journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Efficacy and safety of urate-lowering agents in asymptomatic hyperuricemia: systematic review and network meta-analysis of randomized controlled trials.BMC nephrology · 2022Pooled it
- 2020 American College of Rheumatology Guideline for the Management of Gout.Arthritis care & research · 2020Guideline
- GLUT9 as a potential drug target for chronic kidney disease: Drug target validation by a Mendelian randomization study.Journal of human genetics · 2023Article
- Hyperuricemia, a Non-Independent Component of Metabolic Syndrome, Only Predicts Renal Outcome in Chronic Kidney Disease Patients without Metabolic Syndrome or Diabetes.Biomedicines · 2022Article
- Effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on serum urate levels in patients with and without diabetes: a systematic review and meta-regression of 43 randomized controlled trials.Therapeutic advances in chronic disease · 2022Article
- Multiparametric MRI analysis for the evaluation of renal function in patients with hyperuricemia: a preliminary study.BMC medical imaging · 2021Article
- What is the diagnostic value of dual-energy computed tomography in patients with clinical diagnosis of gout?Advances in rheumatology (London, England) · 2021Article
- Pro-Aging Effects of Xanthine Oxidoreductase Products.Antioxidants (Basel, Switzerland) · 2020Review
- Febuxostat is superior to allopurinol in delaying the progression of renal impairment in patients with chronic kidney disease and hyperuricemia.International urology and nephrology · 2019Article
- To treat or not to treat asymptomatic hyperuricemia in chronic kidney disease.Kidney research and clinical practice · 2019Article
- The Role of a "Treat-to-Target" Approach in the Long-Term Renal Outcomes of Patients with Gout.Journal of clinical medicine · 2019Article
- Urate-lowering agents for asymptomatic hyperuricemia in stage 3 - 4 chronic kidney disease: Controversial role of kidney function.PloS one · 2019Article
- Assessment of allopurinol use in patients with chronic kidney disease and asymptomatic hyperuricemia: a retrospective cohort study.Jornal brasileiro de nefrologiaArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextHyperuricemia is an independent risk factor for progression of kidney disease.
objectiveTo determine whether lowering serum uric acid level (sUA) to below 6 mg/dL (target) improves mild to moderate chronic kidney disease (CKD) and whether CKD stage influences the benefit of lowering sUA to target.
designRetrospective epidemiologic cohort study conducted over 8 years. Estimated glomerular filtration rate (eGFR) was required in the 6 months preceding the index date (defined as first occurrence of sUA < 7 mg/dL), and at least 1 sUA and eGFR were required during follow-up. Patients were urate-lowering therapy (ULT) naïve, aged 18 years or older, and had CKD Stages 2 to 4 at baseline. Health Plan enrollment with drug benefit was required. Exclusions included active cancer, dialysis, or other kidney disease.
main outcome measuresA 30% decrease or 30% improvement in eGFR from baseline.
resultsA total of 12,751 patients met inclusion criteria; 2690 patients received ULT during follow-up and 10,061 did not. Target sUA was achieved in 1118 patients (42%) receiving ULT. A 30% improvement in eGFR was likelier in patients who achieved the target (odds ratio [OR] = 1.78, p < 0.001). Pairwise comparison of CKD stages showed a 30% improvement in eGFR in CKD Stage 2 (OR = 2.26, p = 0.017) and Stage 3 (OR = 2.23, p < 0.001) but not Stage 4 (OR = 1.50, p = 0.081).
conclusionPatients who achieve an American College of Rheumatology target sUA below 6 mg/dL during ULT have higher rates of eGFR improvement, especially in CKD Stages 2 and 3.
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