Uric acid lowering for slowing CKD progression after the CKD-FIX trial: a solved question or still a dilemma?
Giovanna Leoncini, Cecilia Barnini, Luca Manco, Alessandro Nobili, Daniele Dotta, Martina Penso, Elisa Russo, Francesca Cappadona, Francesca Viazzi, Roberto Pontremoli
Abstract
studies as well as animal models highlighted a role for uric acid in the development and progression of haemodynamic and tissue damage at the renal level leading to glomerular and tubulointerstitial abnormalities. Urate-lowering treatment, especially by xanthine oxidase inhibitors, has been proposed in order to improve kidney outcomes. However, recent randomized controlled trials failed to demonstrate a beneficial effect of allopurinol or febuxostat on renal disease, casting doubts on the role of this therapeutical approach to improve nephroprotection. We provide a critical overview of current literature on this topic and offer a possible interpretation of results from recent intervention trials with urate-lowering treatment on renal outcomes.