EFFECTS OF ALLOPURINOL ON RENAL FUNCTION DECLINE IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASES

Aim: To evaluate retrospectively the effects of allopurinol treatment on renal function decline in non-gouty hypertensive patients with moderate-to-severe CKD. Methods: We selected 22 patients treated with allopurinol (A) (100–300 mg/die) that were compared with 44 subjects not treated with this drug (B), matched with A for estimated glomerular filtration rate (eGFR), age, gender and blood pressure values. Results: After a mean follow-up period of 16 months no significant difference was observed between the two groups regarding eGFR decline (A: -6.8 ± 11.6 ml/min/1.73 m2; B: -4.2 ± 9.3 ml/min/1.73 m2). Furthermore, the percentage of subjects with a value of eGFR reduction above the median was not significantly different in the two groups (A: 59 %; B: 41 %; p = 0.16). The absence of a significant effect of allopurinol on the eGFR decline was confirmed by the multiple logistic regression analysis, where the variables associated with a greater eGFR reduction were the proteinuria and the baseline value of GFR. Conclusions: Our findings are in disagreement with previous studies showing a nephroprotective effect of allopurinol. Further studies, with a randomized controlled design, are needed to understand whether or not pharmacological treatment of asymptomatic hyperuricemia may preserve renal function.