Journal Club - Colchicine use tied to lower risk of chronic kidney disease Study

A recent study in the journal Rheumatology has found that Colchicine use may lower the risk of chronic kidney disease (CKD) progression, chronic kidney disease progression was defined asmorethan or equal to 40% decrease from the baseline estimated glomerular filtration rate or the onset of kidney failure with replacement therapy.

Preclinical evidence has suggested protective effects of colchicine against kidney fibrosis, despite this, it is not known if colchicine could delay chronic kidney disease progression in humans. To fill this knowledge gap, SeungHyeok Han, Yonsei University, Seoul, Korea, and colleagues aimed to examine the association between long-term colchicine use and the risk of adverse kidney outcomes in chronic kidney disease patients who were treated for hyperuricemia or chronic gout in a multicentre, nested, case-control study conducted in three Korean hospitals.

The study included patients aged more than or equal to 19 years; who had chronic kidney diseasestage G3 orG4; and used drugs including colchicine, allopurinol, and febuxostat for hyperuricemia or chronic gout from April 2000 to October 2020. Patients with chronic kidney disease progression were matched to controls based on follow-up time, age, and sex.

A total of 3085 patients with chronic kidney disease progression were matched to 11715 control patients.

Based on the study, the researchers reported the following findings:

• Multivariate conditional logistic regression analysis showed that patients with morethan or equal to 90 cumulative daily colchicine doses were associated with a lower risk of CKD progression than non-users.

• In the sensitivity analysis with matched CKD stages, the adjusted odds ratio was 0.77. This association was more pronounced in patients without diabetes or hypertension, and in patients with CKD stage G3.

To conclude, colchicine use is associated with a lower risk of adverse kidney outcomes in chronic kidney disease patients with hyperuricemia, or chronic gout.

Researchers said that "Our findings warrant well-designed [randomized controlled trials] in the future to test the potential renoprotective effects of colchicine in CKD patients," according to Dr Han's team, including finding an optimal dose.

The researchers noted that Colchicine interferes with microtubule polymerization and neutrophil function and it has anti-inflammatory and anti-fibrotic effects.