ArticleDiabetes care2019
Preventing Early Renal Loss in Diabetes (PERL) Study: A Randomized Double-Blinded Trial of Allopurinol-Rationale, Design, and Baseline Data.
Open access · bronzeAbstract readClinical Trial Protocol
In one paragraph
Article in Diabetes care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 4% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Uric acid in CKD: has the jury come to the verdict?Journal of nephrology · 2020Pooled it
- Poor Glycemic Control Is Associated With More Rapid Kidney Function Decline After the Onset of Diabetic Kidney Disease.The Journal of clinical endocrinology and metabolism · 2024Trial
- Effects of febuxostat on delaying chronic kidney disease progression: a randomized trial in China.International urology and nephrology · 2023Trial
- Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 Diabetes.The New England journal of medicine · 2020Trial
- Dynamic Uric Acid Changes and Outcomes in CKD in the African American Study of Kidney Disease and Hypertension.Kidney international reports · 2025Article
- Kidney Tubular Biomarkers in Type 1 Diabetes - Longitudinal Analysis of 2 Cohorts.Kidney international reports · 2025Article
- A comparative study of postadrenalectomy hyperuricemia and renal impairment in patients with unilateral primary aldosteronism: does histopathology subtype matter?BMC nephrology · 2024Article
- SGLT2 Inhibitors and Uric Acid Homeostasis.Gout, urate, and crystal deposition disease · 2024Article
- Performance of GFR Estimating Equations in Young Adults.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Article
- Discordance Between Creatinine-Based and Cystatin C-Based Estimated GFR: Interpretation According to Performance Compared to Measured GFR.Kidney medicine · 2023Article
- NADPH oxidase inhibitor development for diabetic nephropathy through water tank model.Kidney research and clinical practice · 2022Article
- Rationale, design, demographics and baseline characteristics of the randomized, controlled, Phase 2b SAPPHIRE study of verinurad plus allopurinol in patients with chronic kidney disease and hyperuricaemia.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022Article
- The Diabetic Cardiorenal Nexus.International journal of molecular sciences · 2022Review
- Early Trajectory of Estimated Glomerular Filtration Rate and Long-term Advanced Kidney and Cardiovascular Complications in Type 1 Diabetes.Diabetes care · 2022Article
- Update on pathogenesis and diagnosis flow of normoalbuminuric diabetes with renal insufficiency.European journal of medical research · 2021Review
- Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy.Diagnostics (Basel, Switzerland) · 2021Review
- Sodium-Glucose Cotransporter 2 Inhibitors and the Kidney.Diabetes spectrum : a publication of the American Diabetes Association · 2021Article
- Long-Term Longitudinal Stability of Kidney Filtration Marker Measurements: Implications for Epidemiological Studies and Clinical Care.Clinical chemistry · 2021Article
- The Pattern of Allopurinol Prescription Among Chronic Kidney Disease Patients in a Tertiary Care Centre: A Single-Centre Experience.International journal of general medicine · 2021Article
- Uric acid and risk of diabetic kidney disease.Journal of nephrology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
34 authors at 20 institutions in 4 countries.
Maryam AfkarianDivision of Nephrology, Department of Medicine, University of California, Davis, Davis, CA.ORCID 0000-0001-8428-8264
Sarit PolskyBarbara Davis Center for Diabetes, University of Colorado, Aurora, CO.ORCID 0000-0002-7602-0396
Afshin ParsaDivision of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
Ronnie AronsonLMC Diabetes & Endocrinology, Toronto, Ontario, Canada.ORCID 0000-0002-8976-2321
Maria Luiza CaramoriDepartments of Pediatrics and Medicine, University of Minnesota, Minneapolis, MN.
David Z CherneyDepartments of Medicine and Physiology, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0003-4164-0429
Jill P CrandallDepartment of Medicine, Albert Einstein College of Medicine, New York, NY.
Ian H de BoerDepartment of Medicine, University of Washington, Seattle, WA.ORCID 0000-0003-1571-7592
Thomas G ElliottBCDiabetes, Vancouver, British Columbia, Canada.ORCID 0000-0002-4626-6440
Andrzej T GaleckiDivision of Geriatrics, Institute of Gerontology, University of Michigan, Ann Arbor, MI.
Allison B GoldfineResearch Division, Joslin Diabetes Center, and Department of Medicine, Harvard Medical School, Boston, MA.
J Sonya HawDepartment of Medicine, Emory University, Atlanta, GA.
Irl B HirschDepartment of Medicine, University of Washington, Seattle, WA.ORCID 0000-0003-1675-8417
Amy B KargerDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
Ildiko LingvayDepartment of Internal Medicine and Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX.ORCID 0000-0001-7006-7401
David M MaahsDepartment of Pediatrics, Stanford University, Palo Alto, CA.
Janet B McGillDepartment of Medicine, Washington University School of Medicine, St. Louis, MO.
Mark E MolitchDivision of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.ORCID 0000-0002-8492-3587
Bruce A PerkinsLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, and Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-5885-0046
Rodica Pop-BusuiDivision of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.ORCID 0000-0002-2042-1350
Marlon PragnellJDRF, New York, NY.
Sylvia E RosasResearch Division, Joslin Diabetes Center, and Department of Medicine, Harvard Medical School, Boston, MA.
Peter RossingSteno Diabetes Center Copenhagen, Gentofte, Denmark.
Peter SeniorDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Ronald J SigalDepartments of Medicine, Cardiac Sciences, and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada.
Catherine SpinoStatistical Analysis of Biomedical and Educational Research, Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI.
Katherine R TuttleProvidence Health Care, Spokane, WA.
Guillermo E UmpierrezDepartment of Medicine, Emory University, Atlanta, GA.ORCID 0000-0002-3252-5026
Amisha WalliaDivision of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.ORCID 0000-0002-3183-4062
Ruth S WeinstockDepartment of Medicine, State University of New York Upstate Medical University, Syracuse, NY.
Chunyi WuDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI.
Michael MauerDepartments of Pediatrics and Medicine, University of Minnesota, Minneapolis, MN.
Alessandro DoriaORCID 0000-0002-3830-4304
PERL Study Group
University of Minnesota · USJoslin Diabetes Center · USUniversity of Michigan · USNorthwestern University · USAlbert Einstein College of Medicine · USEmory University · USUniversity of Copenhagen · DKUniversity of Washington · USLMC Diabetes & Endocrinology (Canada) · CAMount Sinai Hospital · CANational Institute of Diabetes and Digestive and Kidney Diseases · USThe University of Texas Southwestern Medical Center · USUniversity of Alberta · CAStanford University · USSUNY Upstate Medical University · USUniversity of Calgary · CAUniversity of California, Davis · USUniversity of Colorado Anschutz Medical Campus · USBreakthrough T1D · USUniversity of Toronto · CA
Funding
Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0MNorthwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8MSPECIAL ASSAY COREP30DK036836 · NIDDK · JOSLIN DIABETES CENTER · PI ROHIT N. KULKARNI · 1986 to 2026
$50.5MUniversity of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9MPERL: A multicenter clinical trial of allopurinol to prevent GFR loss in T1DUC4DK101108 · NIDDK · JOSLIN DIABETES CENTER · PI DORIA, ALESSANDRO, MAUER, S. MICHAEL · 2013 to 2018
$31.6MResearch Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2MCTSA Administrative Supplement for Informatics Core: A novel AI/ML system to predict respiratory failure and ARDS in Covid-19 patientsUL1TR002556 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, KIM, MIMI Y · 2018 to 2022
$26.7MUT Southwestern Center for Translational Medicine (UL1/KL2/TL1)UL1TR001105 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2013 to 2017
$24.5MRegional Pilot And Feasibility Study Grants ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Mehboob A Hussain · 2013 to 2026
$24.3MWeight gain trajectory and life spanP60AG008808 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HALTER, JEFFREY B. · 1994 to 2003
$5.9MA multicenter clinical trial of allopurinol to prevent GFR loss in T1DR34DK097808 · NIDDK · JOSLIN DIABETES CENTER · PI DORIA, ALESSANDRO, MAUER, S. MICHAEL · 2012 to 2012
$190kDesign of a Multicenter Clinical Trial of Allopurinol to Prevent GFR Loss in T1DR03DK094484 · NIDDK · JOSLIN DIABETES CENTER · PI DORIA, ALESSANDRO, MAUER, S. MICHAEL · 2011 to 2011
$107kNCATS NIH HHS UL1 TR001105NCATS NIH HHS UL1 TR001422NCATS NIH HHS UL1 TR002319NCATS NIH HHS UL1 TR002494NCATS NIH HHS UL1 TR002556NIA NIH HHS P30 AG024824NIA NIH HHS P60 AG008808NIDDK NIH HHS P30 DK020572NIDDK NIH HHS P30 DK036836NIDDK NIH HHS R03 DK094484NIDDK NIH HHS R34 DK097808NIDDK NIH HHS UC4 DK101108
Abstract
objectiveHigher serum uric acid (SUA) is associated with diabetic kidney disease (DKD). Preventing Early Renal Loss in Diabetes (PERL) evaluates whether lowering SUA with allopurinol slows glomerular filtration rate (GFR) loss in people with type 1 diabetes (T1D) and mild to moderate DKD. We present the PERL rationale, design, and baseline characteristics. RESEARCH DESIGN AND
methodsThis double-blind, placebo-controlled, multicenter trial randomized 530 participants with T1D, estimated GFR (eGFR) of 40-99.9 mL/min/1.73 m
resultsParticipants are 66% male and 84% white. At baseline, median age was 52 years and diabetes duration was 35 years, 93% of participants had hypertension, and 90% were treated with renin-angiotensin system inhibitors (median blood pressure 127/71 mmHg). Median HbA
conclusionsPERL will determine the effect of allopurinol on mild to moderate DKD in T1D, with or without albuminuria. Participants with normoalbuminuria and rapid GFR loss manifested many DKD risk factors of those with albuminuria, but with less severity.
Indexed as
AgedAlbuminuriaAllopurinolBlood PressureDiabetes Mellitus, Type 1Diabetic NephropathiesDisease ProgressionDouble-Blind MethodFemaleGlomerular Filtration RateHumansMaleMiddle AgedRandomized Controlled Trials as TopicRenin-Angiotensin SystemRisk FactorsAllopurinolUric Acid
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.