Original InvestigationPathogenesis and Treatment of Kidney DiseaseAllopurinol and Progression of CKD and Cardiovascular Events: Long-term Follow-up of a Randomized Clinical Trial
Section snippets
Study Design
The design of the previous randomized controlled trial (RCT) has been described elsewhere.1 Briefly, 113 patients with eGFRs < 60 mL/min/1.73 m2, stable clinical condition (no hospitalizations or cardiovascular events within the 3 months before screening), and stable kidney function were randomly assigned according to a computer-generated list to continue with their standard treatment (control group) or to treatment with allopurinol at 100 mg/d. The dosage of antihypertensive drugs, lipid-lowering
Patient Flow
Baseline characteristics, previous cardiovascular diseases, concomitant medication, and laboratory parameters have been described elsewhere1 and are listed in Table 1. In the original study, 113 participants (57 in the allopurinol group and 56 in the control group) initially were followed up for 2 years. In the long-term follow-up reported here, 107 participants were followed up to 5 additional years (56 in the allopurinol group because 1 patient was lost to follow-up and 51 in the control
Discussion
This post hoc intention-to-treat analysis of previously published study data shows that the beneficial effect of treatment with allopurinol on progression of kidney disease and cardiovascular risk was maintained in the long term.1 After a median follow-up of 7 years, allopurinol was shown to reduce the risk of renal events by 68% and the risk of cardiovascular events by 57%. Our study design is strengthened by the use of a renal end point that included initiation of dialysis therapy and
Acknowledgements
Support: None.
Financial Disclosure: The authors declare that they have no relevant financial interests.
Contributions: Research idea and study design: MG, SMGdV, JL; data acquisition: MG, SMGdV, UV, EV, NM, AS, APdJ, SC, TL; statistical analysis: MG, JL; supervision or mentorship: MG, SMGdV, LJ. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or
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