PMID- 35856157
OWN - NLM
STAT- MEDLINE
DCOM- 20220721
LR  - 20220724
IS  - 1525-6049 (Electronic)
IS  - 0886-022X (Print)
IS  - 0886-022X (Linking)
VI  - 44
IP  - 1
DP  - 2022 Dec
TI  - Effects of allopurinol on renal function in patients with diabetes: a systematic 
      review and meta-analysis.
PG  - 806-814
LID - 10.1080/0886022X.2022.2068443 [doi]
AB  - BACKGROUND/OBJECTIVE: Diabetes mellitus is a common "non-gout" disease with high 
      incidence. Several studies have shown that serum uric acid level in patients with 
      diabetes is higher than that in healthy individuals, and is accompanied by severe 
      albuminuria and high serum creatinine (Scr). Recent clinical studies have found 
      that uric acid-lowering therapy (such as allopurinol) could reduce urinary 
      albumin excretion rates (UAER) and Scr, increase eGFR, and thus reduce kidney 
      damage in patients with diabetes. Therefore, this meta-analysis [PROSPERO 
      CRD42021274465] intended to evaluate the efficacy and safety of allopurinol in 
      patients with diabetes mellitus. METHODS: We thoroughly searched five electronic 
      resource databases for randomized controlled trials (RCTs) that compared the 
      efficacy and safety of allopurinol versus conventional treatment or placebo for 
      the treatment of patients with diabetes mellitus. Predetermined outcomes were 
      considered continuous variables, mean difference (MD) was used for the 
      determination of effect size (standardized mean difference [SMD] was used to 
      determine the effect size when there were different evaluation criteria in 
      different articles), and the corresponding 95% confidence interval (CI) was 
      calculated. All outcome measures were analyzed using a random-effects model for 
      data analysis. RESULTS: Ten eligible trials with a total of 866 participants were 
      included in the meta-analysis. Allopurinol was more effective in decreasing serum 
      uric acid (SUA) levels compared with conventional treatment (p = 0.0001) or 
      placebo (p < 0.00001). Moreover, the levels of 24-hour urine protein were 
      significantly lower in the allopurinol group (p < 0.00001). The subgroup analysis 
      of Scr showed that the Scr of patients with an allopurinol treatment duration of 
      fewer than six months was significantly lower than that of the control group 
      (p = 0.03). No significant difference in adverse events (AEs) was identified 
      between the treatment and control groups. CONCLUSIONS: Our meta-analysis of RCTs 
      showed that oral administration of allopurinol effectively reduced SUA levels in 
      patients with diabetes, and patients' renal function was protected. More RCTs 
      with larger sample sizes and higher quality are needed to clarify the role of 
      allopurinol use in decreasing blood pressure, maintaining blood glucose levels, 
      and improving renal function in patients with diabetes.
FAU - Luo, Qian
AU  - Luo Q
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 
      University of Chinese Medicine, Beijing, China.
AD  - Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, 
      Beijing, China.
FAU - Cai, Yuzi
AU  - Cai Y
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 
      University of Chinese Medicine, Beijing, China.
AD  - Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, 
      Beijing, China.
FAU - Zhao, Qihan
AU  - Zhao Q
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 
      University of Chinese Medicine, Beijing, China.
AD  - Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, 
      Beijing, China.
FAU - Tian, Lei
AU  - Tian L
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 
      University of Chinese Medicine, Beijing, China.
AD  - Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, 
      Beijing, China.
FAU - Liu, Yuning
AU  - Liu Y
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 
      University of Chinese Medicine, Beijing, China.
AD  - Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, 
      Beijing, China.
FAU - Liu, Wei Jing
AU  - Liu WJ
AUID- ORCID: 0000-0002-5356-7057
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 
      University of Chinese Medicine, Beijing, China.
AD  - Zhanjiang Key Laboratory of Prevention and Management of Chronic Kidney Disease, 
      Guangdong Medical University, Zhanjiang, Guangdong, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - England
TA  - Ren Fail
JT  - Renal failure
JID - 8701128
RN  - 0 (Gout Suppressants)
RN  - 268B43MJ25 (Uric Acid)
RN  - 63CZ7GJN5I (Allopurinol)
SB  - IM
MH  - Allopurinol/therapeutic use
MH  - *Diabetes Mellitus/chemically induced/drug therapy
MH  - *Gout
MH  - Gout Suppressants
MH  - Humans
MH  - *Hyperuricemia/drug therapy
MH  - Kidney/physiology
MH  - Uric Acid
PMC - PMC9307109
OTO - NOTNLM
OT  - Diabetes mellitus
OT  - allopurinol
OT  - hyperuricemia
OT  - meta-analysis
OT  - renal function
COIS- No potential conflict of interest was reported by the author(s).
EDAT- 2022/07/21 06:00
MHDA- 2022/07/22 06:00
PMCR- 2022/07/20
CRDT- 2022/07/20 04:16
PHST- 2022/07/20 04:16 [entrez]
PHST- 2022/07/21 06:00 [pubmed]
PHST- 2022/07/22 06:00 [medline]
PHST- 2022/07/20 00:00 [pmc-release]
AID - 2068443 [pii]
AID - 10.1080/0886022X.2022.2068443 [doi]
PST - ppublish
SO  - Ren Fail. 2022 Dec;44(1):806-814. doi: 10.1080/0886022X.2022.2068443.