Abstract

In people with existing kidney disease, one in four will have worse disease within six to 12 months. Uric acid-lowering drugs such as allopurinol halve the risk of disease progression over this period. They also reduce heart attack or stroke by 60%. Uric acid, the cause of gout, is produced when proteins are broken down by the body. It is excreted by the kidneys and often builds up in people with chronic kidney disease. It is not certain whether increased uric acid causes progression of kidney disease or is simply a marker of its severity. This review included 16 small trials of 1,211 people with moderate chronic kidney disease from a variety of causes which were allocated to take a uric acid lowering medication or usual care. Although these results are promising, they are based on low-quality trials. The low rate of side effects should be taken into account when considering these drugs as an option to slow the progression of kidney failure and prevent heart disease.