PMID- 34413775
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210821
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 12
DP  - 2021
TI  - Effectiveness of Drug Treatments for Lowering Uric Acid on Renal Function in 
      Patients With Chronic Kidney Disease and Hyperuricemia: A Network Meta-Analysis 
      of Randomized Controlled Trials.
PG  - 690557
LID - 10.3389/fphar.2021.690557 [doi]
LID - 690557
AB  - Background: Hyperuricemia is very common in patients with chronic kidney disease 
      (CKD); the role of hyperuricemia in the occurrence and progression of kidney 
      disease remains an interesting and unresolved issue for nephrologists, and 
      whether urate-lowering therapy (ULT) is warranted in CKD patients is still in 
      controversy. To summarize and compare the clinical outcomes and adverse events 
      (AEs) of three common ULT drugs, we performed a systematic review and network 
      meta-analysis of randomized clinical trials (RCTs). Method: PubMed, MEDLINE, 
      Clinical Trials.gov, EMBASE, and the Cochrane Central Register of Controlled 
      Trials electronic databases were searched. The network meta-analysis was 
      performed using the "gemtc 0.8-7" and its dependent packages in R software. The 
      primary outcome was the change of renal function and uric acid; creatinine, 
      proteinuria, blood pressure, and adverse events were assessed as the secondary 
      outcomes. Results: 16 RCTs involving 1,943 patients were included in the final 
      network analysis. Febuxostat, allopurinol, and benzbromarone were not found to 
      exert superior effects over placebo upon renoprotective effect. With respect to 
      lowering urate, the three drugs showed to be statistically superior to placebo, 
      while febuxostat could better lower urate than allopurinol (MD: -1.547; 95% CrI: 
      -2.473 to -0.626). It is also indicated that febuxostat was superior to placebo 
      at controlling blood pressure, while no differences were observed when 
      allopurinol and benzbromarone were compared to placebo. These results are stable 
      in subgroup analysis. Conclusion: There is insufficient evidence to support the 
      renoprotective effects of the three urate-lowering agents in CKD patients with 
      hyperuricemia; febuxostat shows a tendency to be superior to allopurinol on 
      lowering the decline of eGFR and increment of proteinturia, but the difference 
      does not reach a statistical significance. Regarding its urate-lowering effect, 
      febuxostat appears to be a satisfactory alternative to allopurinol and 
      benzbromarone, and can control blood pressure better.
CI  - Copyright (c) 2021 Liu, Qiu, Li, Tan, Liang and Qin.
FAU - Liu, Xiang
AU  - Liu X
AD  - Division of Nephrology, Department of Medicine, West China Hospital, Sichuan 
      University, Chengdu, China.
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
FAU - Qiu, Yuxuan
AU  - Qiu Y
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
AD  - Division of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
FAU - Li, Duohui
AU  - Li D
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
FAU - Tan, Jiaxing
AU  - Tan J
AD  - Division of Nephrology, Department of Medicine, West China Hospital, Sichuan 
      University, Chengdu, China.
FAU - Liang, Xiuping
AU  - Liang X
AD  - West China School of Medicine, Sichuan University, Chengdu, China.
FAU - Qin, Wei
AU  - Qin W
AD  - Division of Nephrology, Department of Medicine, West China Hospital, Sichuan 
      University, Chengdu, China.
LA  - eng
PT  - Journal Article
DEP - 20210803
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC8369347
OTO - NOTNLM
OT  - allopurinol
OT  - benzbromarone
OT  - chronic kidney disease
OT  - febuxostat
OT  - hyperuricemia
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/08/21 06:00
MHDA- 2021/08/21 06:01
PMCR- 2021/08/03
CRDT- 2021/08/20 07:01
PHST- 2021/04/03 00:00 [received]
PHST- 2021/06/30 00:00 [accepted]
PHST- 2021/08/20 07:01 [entrez]
PHST- 2021/08/21 06:00 [pubmed]
PHST- 2021/08/21 06:01 [medline]
PHST- 2021/08/03 00:00 [pmc-release]
AID - 690557 [pii]
AID - 10.3389/fphar.2021.690557 [doi]
PST - epublish
SO  - Front Pharmacol. 2021 Aug 3;12:690557. doi: 10.3389/fphar.2021.690557. 
      eCollection 2021.