Kidney Deterioration Not Aggravated by Allopurinol

Allopurinol is not associated with an increased risk of renal function deterioration, a study presented on Nov. 14 at the American College of Rheumatology annual meeting shows.

The study, which was presented by Ana Beatriz Vargas-Santos of the Boston University School of Medicine, was also published in Arthritis & Rheumatology concluding that allopurinol therapy to lower uric acid levels in gout does not increase the risk of renal failure in gout patients.

The studies send an important message to health care providers, highlighting that therapy for gout with allopurinol should not have a harmful effect on renal function.

Allopurinol is commonly used for lowering uric acid levels in gout but some doctors are hesitant to prescribe it for patients with chronic kidney disease. “There is emerging evidence that urate-lowering therapy (ULT) may be beneficial in subjects with renal dysfunction. Whether patients with gout may experience less CKD with allopurinol is not clear,” the researchers wrote.

The authors conducted a cohort study utilizing The Health Improvement Network (THIN) database and included adults with gout and at least one contact with a general practitioner within a year. Patients with stage 3 or worse kidney disease prior to gout diagnosis were excluded. A total of 13,727 patients started on allopurinol therapy were propensity score matched with 13,727 patients not taking the drug. From the two groups 1401 allopurinol users developed chronic kidney disease stage 3 or greater, while 1319 of the non-users did.

Taking allopurinol did not increase the risk of developing chronic kidney disease stage 3 or greater compared to patients not taking it (hazard ratio 1.05, 95% CI 0.97-1.13). No significant change in results occurred when adjustment was made for confounders.

References:

Ana Beatriz Vargas-Santos. "No Increased Risk of Chronic Kidney Disease with Allopurinol Use," Abstract number 1957. 11:30 a.m., Nov. 14, 2016. ACR/ARHP 2016 Annual Meeting.