Effect of Uric-acid-lowering Therapy on Progression of Chronic Kidney Disease: A Meta-analysis

【摘要】 The efficacy and safety of uric-acid-lowering therapy(UALT) on slowing the progression of chronic kidney disease(CKD) accompanied by hyperuricemia were assessed. We searched Cochrane Library, PubMed, EMbase, CNKI, Wanfang and Vip databases up to November 15, 2012 for randomized controlled trials(RCTs) which compared the effect of UALT to control therapy in hyperuricemic patients secondary to CKD, and then performed quality evaluation and meta-analysis on the included studies. Seven RCTs involving 451 cases were included. UALT delayed the increase of serum creatinine(MD=–62.55 μmol/L, 95% CI: –98.10 to –26.99) and blood urea nitrogen(MD= –6.15 mmol/L, 95% CI:–8.17 to –4.13) as well as the decrease of glomerular filtration rate [MD=5.65 mL/(min·1.73 m2), 95% CI: 1.88 to 9.41], decreased systolic blood pressure(SBP)(MD= –6.08 mmHg, 95% CI: –11.67 to –0.49), and reduced the risk of the renal disease progression(RR=0.30, 95% CI: 0.19 to 0.46). However, there was no statistically significant difference in 24-h urinary protein quantity and diastolic blood pressure(P>0.05). We identified that UALT could delay the progression of CKD with secondary hyperuricemia. And this also indirectly proved that hyperuricemia was a risk factor for the CKD progression.更多还原

【Abstract】 The efficacy and safety of uric-acid-lowering therapy(UALT) on slowing the progression of chronic kidney disease(CKD) accompanied by hyperuricemia were assessed. We searched Cochrane Library, PubMed, EMbase, CNKI, Wanfang and Vip databases up to November 15, 2012 for randomized controlled trials(RCTs) which compared the effect of UALT to control therapy in hyperuricemic patients secondary to CKD, and then performed quality evaluation and meta-analysis on the included studies. Seven RCTs involving 451 cases were included. UALT delayed the increase of serum creatinine(MD=–62.55 μmol/L, 95% CI: –98.10 to –26.99) and blood urea nitrogen(MD= –6.15 mmol/L, 95% CI:–8.17 to –4.13) as well as the decrease of glomerular filtration rate [MD=5.65 mL/(min·1.73 m2), 95% CI: 1.88 to 9.41], decreased systolic blood pressure(SBP)(MD= –6.08 mmHg, 95% CI: –11.67 to –0.49), and reduced the risk of the renal disease progression(RR=0.30, 95% CI: 0.19 to 0.46). However, there was no statistically significant difference in 24-h urinary protein quantity and diastolic blood pressure(P>0.05). We identified that UALT could delay the progression of CKD with secondary hyperuricemia. And this also indirectly proved that hyperuricemia was a risk factor for the CKD progression.更多还原