Febuxostat slows eGFR decline in CKD patients of stages 3 and 4 with asymptomatic hyperuricemia

Previous studies have mentioned the usefulness of febuxostat in delaying chronic kidney disease (CKD) progression as it treats hyperuricemia. But the results remain controversial.

The researchers of the team led by Dr Hongtao Yang from the Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China, did a randomized controlled study which included the Chinese population with a history of advanced CKD.

The study points are summarised below:

• One hundred patients from seven medical centres having CKD stages 3 and 4 with asymptomatic hyperuricemia were included in the study.
• There were two groups, control and febuxostat.
• The latter received febuxostat to titrate to achieve serum uric acid (SUA) < 6 mg/dL.
• Estimated glomerular filtration rate (eGFR) decline ≥ 30% or 50% were the primary outcomes measured in the study.
• The change in eGFR was the secondary outcome measured in the study.
• The researchers also performed a Safety analysis.
• Forty-seven patients in the febuxostat and 45 in the control groups completed the study.
• In the febuxostat group, seven patients constituting 14.9% of participants, had a 30% decline in eGFR, while 1 (2.1%) and 2 (4.3%) patients reached a 50% decline in eGFR or dialysis.
• Out of 45 patients in the control group, 13, 10, and 3 patients constituting 28.9 %, 22.2%, and 6.7 %, reached primary kidney outcomes separately.
• In the febuxostat group, the change in eGFR after 12 months from baseline was 0.50 mL/min/1.73 m2.
• In the control group, the change in eGFR was − 4.46 mL/min/1.73 m2.
• There was no difference in adverse events between the two groups.

To conclude, Febuxostat slowed eGFR decline in CKD patients of stages 3 and 4 and asymptomatic hyperuricemia. There was a significantly greater change in eGFR in the Febuxostat group compared to the control group.

Further reading:

Yang, H., Li, R., Li, Q. et al. Effects of febuxostat on delaying chronic kidney disease progression: a randomized trial in China. Int Urol Nephrol (2022). https://doi.org/10.1007/s11255-022-03437-5