Impact of urate-lowering drugs on the progression and recovery from chronic kidney disease among gout patients.

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ID: 48166
2019
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Abstract
This study investigates the association between exposure to urate-lowering drugs (ULDs) and progression and recovery from chronic kidney disease (CKD).We identified 5860 incident gout patients at Chang Gung Memorial Hospital from 2012 to 2015. Propensity score (PS)-weighted Cox proportional hazards model was used to estimate hazard ratios (HRs) for CKD progression and improvement. A separate analysis was conducted to assess the HR for CKD progression and CKD recovery among those with worsening CKD.The incidence of CKD progression among allopurinol, febuxostat and uricosuric agent users were 1.98, 1.88 and 1.64 per 1000 person-days. Compared with allopurinol users, the PS-weighted HR (95% confidence intervals [CIs]) was 1.77 (0.85-1.76) for febuxostat users and 1.37 (0.71-1.37) for uricosuric agent users for CKD progression and 1.43 (1.26-1.62) for febuxostat users and 1.00 (0.88-1.14) for uricosuric agent users for CKD improvement. Compared to allopurinol users, the HRs for CKD progression were 1.14 (0.80-1.66) for febuxostat users and 0.92 (0.67-1.31) for uricosuric agent users. Among 741 patients who had CKD progression, the incidence of CKD recovery was 1.33, 6.21 and 3.53 per 1000 person-days for allopurinol, febuxostat and uricosuric agent users. The HRs (95% CIs) for recovery in febuxostat and uricosuric agent users were 2.17 (1.40-3.47) and 1.80 (1.20-2.83) compared to allopurinol users.CKD progression and recovery are common in gout patients using ULDs. Febuxostat and benzbromarone were associated with a similar risk of CKD progression with allopurinol, which has a poorer recovery compared with other ULDs.
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chung2019impactarthritis Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Chung, Ting-Ting;Yu, Kuang-Hui;Kuo, Chang-Fu;Luo, Shue-Fen;Chiou, Meng-Jiun;Lan, Wen-Ching;Chen, Jung-Sheng;Tseng, Wen-Yi;Hsieh, Ao-Ho;Wang, Lian-Chin;
Journal arthritis research & therapy
Year 2019
DOI
10.1186/s13075-019-1993-9
URL
Keywords
chronic kidney disease gout renal function allopurinol febuxostat urate-lowering drug uricosuric agents

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