Gout Drug Lowers CKD Risk

Treating patients with gout with allopurinol is associated with a reduced risk for chronic kidney disease (CKD), according to the results of a recent study.

“Clinicians are often cautious about use of allopurinol in patients with gout when renal function declines,” the researchers wrote.

To explore this association, they conducted a time-stratified propensity score-matched, population-based prospective cohort study of patients with newly diagnosed gout who initiated allopurinol (≥300 mg/d) matched 1:1 with patients who did not initiate allopurinol. Individuals with CKD stage 3 or higher or urate-lowering therapy use were excluded.

Of the 4760 allopurinol initiators and non-initiators, 579 and 623 developed CKD stage 3 or higher, respectively. Use of allopurinol ≥300 mg/d was associated with lower risk of developing CKD compared with nonusers, with a hazard ratio of 0.87.

“Because allopurinol did not appear to be associated with renal function decline, clinicians should consider evaluating other factors when faced with renal function decline in their patients with gout rather than lowering the dose of or discontinuing allopurinol, a strategy that has contributed to the ongoing suboptimal treatment of gout.”

—Michael Potts

Reference:

Vargas-Santos AB, Peloquin CE, Zhang Y, et al. Association of chronic kidney disease with allopurinol use in gout treatment [published online October 8, 2018. JAMA Intern Med. doi:10.1001/jamainternmed.2018.4463.