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Effects of uric acid-lowering therapy on the progression of chronic kidney disease: a systematic review and meta-analysis.
Ren Fail. 2018 Nov; 40(1):289-297.RF

Abstract

OBJECTIVES

Whether uric acid levels were associated with the progression of chronic kidney disease (CKD) remained controversial. This meta-analysis was aimed to assess the effect of lowering serum uric acid therapy on the progression of CKD to clarify the role of uric acid in the progression of CKD indirectly.

METHODS

Pubmed, Embase, the Cochrane library, CBM were searched for randomized controlled trials (RCTs) that assessed the efficiency of lowering serum uric acid therapy on the progression of CKD without language restriction. Summary estimates of weighted mean differences (WMDs) and relative risk (RR) were obtained by using random-effect or fixed-effect models. Sensitivity analyses were performed to identify the source of heterogeneity.

RESULTS

A total of 12 randomized controlled trials with 832 CKD participants were included in the analysis. Pooled estimate for eGFR was in favor of lowering serum uric acid therapy with a mean difference (MD) of 3.88 ml/min/1.73 m2, 95% CI 1.26-6.49 ml/min/1.73 m2, p = .004 and this was consistent with results for serum creatinine. The risk of worsening of kidney function or ESRD or death was significantly decreased in the treatment group compared to the control group (RR 0.39, 95% CI 0.28-0.52, p< .01).

CONCLUSIONS

Uric acid-lowering therapy may be effective in retarding the progression of CKD. Further randomized controlled trials should be performed to confirm the effect of lowering serum uric acid therapy on the progression of CKD.

Authors+Show Affiliations

a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China.a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China.a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China.a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China.a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China.a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China.

Pub Type(s)

Evaluation Study
Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29619870

Citation

Liu, Xuemei, et al. "Effects of Uric Acid-lowering Therapy On the Progression of Chronic Kidney Disease: a Systematic Review and Meta-analysis." Renal Failure, vol. 40, no. 1, 2018, pp. 289-297.
Liu X, Zhai T, Ma R, et al. Effects of uric acid-lowering therapy on the progression of chronic kidney disease: a systematic review and meta-analysis. Ren Fail. 2018;40(1):289-297.
Liu, X., Zhai, T., Ma, R., Luo, C., Wang, H., & Liu, L. (2018). Effects of uric acid-lowering therapy on the progression of chronic kidney disease: a systematic review and meta-analysis. Renal Failure, 40(1), 289-297. https://doi.org/10.1080/0886022X.2018.1456463
Liu X, et al. Effects of Uric Acid-lowering Therapy On the Progression of Chronic Kidney Disease: a Systematic Review and Meta-analysis. Ren Fail. 2018;40(1):289-297. PubMed PMID: 29619870.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of uric acid-lowering therapy on the progression of chronic kidney disease: a systematic review and meta-analysis. AU - Liu,Xuemei, AU - Zhai,Tingting, AU - Ma,Ruixia, AU - Luo,Congjuan, AU - Wang,Huifang, AU - Liu,Liqiu, PY - 2018/4/6/entrez PY - 2018/4/6/pubmed PY - 2018/9/19/medline KW - Uric acid KW - chronic kidney disease KW - randomized controlled trials KW - uric acid-lowering therapy SP - 289 EP - 297 JF - Renal failure JO - Ren Fail VL - 40 IS - 1 N2 - OBJECTIVES: Whether uric acid levels were associated with the progression of chronic kidney disease (CKD) remained controversial. This meta-analysis was aimed to assess the effect of lowering serum uric acid therapy on the progression of CKD to clarify the role of uric acid in the progression of CKD indirectly. METHODS: Pubmed, Embase, the Cochrane library, CBM were searched for randomized controlled trials (RCTs) that assessed the efficiency of lowering serum uric acid therapy on the progression of CKD without language restriction. Summary estimates of weighted mean differences (WMDs) and relative risk (RR) were obtained by using random-effect or fixed-effect models. Sensitivity analyses were performed to identify the source of heterogeneity. RESULTS: A total of 12 randomized controlled trials with 832 CKD participants were included in the analysis. Pooled estimate for eGFR was in favor of lowering serum uric acid therapy with a mean difference (MD) of 3.88 ml/min/1.73 m2, 95% CI 1.26-6.49 ml/min/1.73 m2, p = .004 and this was consistent with results for serum creatinine. The risk of worsening of kidney function or ESRD or death was significantly decreased in the treatment group compared to the control group (RR 0.39, 95% CI 0.28-0.52, p< .01). CONCLUSIONS: Uric acid-lowering therapy may be effective in retarding the progression of CKD. Further randomized controlled trials should be performed to confirm the effect of lowering serum uric acid therapy on the progression of CKD. SN - 1525-6049 UR - https://www.unboundmedicine.com/medline/citation/29619870/Effects_of_uric_acid_lowering_therapy_on_the_progression_of_chronic_kidney_disease:_a_systematic_review_and_meta_analysis_ L2 - https://www.tandfonline.com/doi/full/10.1080/0886022X.2018.1456463 DB - PRIME DP - Unbound Medicine ER -