Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis

Yun Shiuan O. Hsu, I. Wen Wu, Shang Hung Chang, Cheng Chia Lee, Chung Ying Tsai, Chan Yu Lin, Wan Ting Lin, Yu Tung Huang, Chao Yi Wu, George Kuo, Chih Yen Hsiao, Hsing Lin Lin, Chih Chao Yang, Tzung Hai Yen, Yung Chang Chen, Cheng Chieh Hung, Ya Chong Tian, Chang Fu Kuo, Chih Wei Yang, Gerard F. AndersonHuang Yu Yang

Research output: Contribution to journalArticlepeer-review

Abstract

Hyperuricemia has been associated with chronic kidney disease (CKD) progression. The antihyperuricemic febuxostat's potential renoprotective effect has been demonstrated in stage 1–3 CKD. Large-scale studies comparing the renoprotective potential of febuxostat and allopurinol in advanced CKD are lacking. We exclusively selected 6,057 eligible patients with predialysis stage 5 CKD prescribed either febuxostat or allopurinol using the National Health Insurance Research Database in Taiwan during 2012–2015. There were 69.57% of allopurinol users and 42.01% febuxostat users who required long-term dialysis (P < 0.0001). The adjusted hazard ratio (HR) of 0.65 (95% confidence interval (CI) 0.60–0.70) indicated near 35% lower hazards of long-term dialysis with febuxostat use. The renal benefit of febuxostat was consistent across most patient subgroups and/or using the propensity score-matched cohort. The adjusted HR was 0.66 (95% CI, 0.61–0.70) for long-term dialysis or death. In conclusion, lower risk of progression to dialysis was observed in predialysis stage 5 CKD febuxostat users without compromising survival.

Original languageEnglish (US)
Pages (from-to)1159-1169
Number of pages11
JournalClinical pharmacology and therapeutics
Volume107
Issue number5
DOIs
StatePublished - May 1 2020

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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