Urate-Lowering Therapy and Chronic Kidney Disease Progression

This editorial discusses two randomized controlled trials (PERL and CKD-FIX) investigating the efficacy of urate-lowering therapy (allopurinol) in slowing chronic kidney disease (CKD) progression. The PERL trial involved patients with type 1 diabetes and early stage CKD, while CKD-FIX included patients with advanced CKD. Neither trial demonstrated a significant benefit of allopurinol in preserving glomerular filtration rate (GFR). The author highlights the discrepancy between epidemiologic associations of uric acid with CKD progression and these negative clinical trial results, suggesting that urate lowering therapy may only be effective in younger patients or earlier CKD stages. The editorial calls for further research to clarify the role of uric acid in CKD pathogenesis.

This editorial discusses two randomized controlled trials (PERL and CKD-FIX) investigating the efficacy of urate-lowering therapy (allopurinol) in slowing chronic kidney disease (CKD) progression. The PERL trial involved patients with type 1 diabetes and early stage CKD, while CKD-FIX included patients with advanced CKD. Neither trial demonstrated a significant benefit of allopurinol in preserving glomerular filtration rate (GFR). The author highlights the discrepancy between epidemiologic associations of uric acid with CKD progression and these negative clinical trial results, suggesting that urate lowering therapy may only be effective in younger patients or earlier CKD stages. The editorial calls for further research to clarify the role of uric acid in CKD pathogenesis.