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Original Paper

Free Access

Clinical Outcome of Hyperuricemia in IgA Nephropathy: A Retrospective Cohort Study and Randomized Controlled Trial

Shi Y.a · Chen W.a · Jalal D.d · Li Z.a, b · Chen W.c · Mao H.a · Yang Q.a · Johnson R.J.d · Yu X.a

Author affiliations

Department of aNephrology and bEpidemiology Research Unit, Translational Medicine Research Centre, and cDepartment of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; dDivision of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colo., USA

Corresponding Author

Wei Chen, MD, PhD

Department of Nephrology

The First Affiliated Hospital, Sun Yat-sen University

58 Zhongshan Road II, Guangzhou 510080 (China)

Tel. +86 20 8776 6335, E-Mail vvchen66@gmail.com

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Kidney Blood Press Res 2012;35:153–160

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Abstract

Background: Hyperuricemia is an independent risk factor for renal progression in IgA nephropathy (IgAN). However, no study has evaluated the effect of allopurinol on the clinical outcome in hyperuricemic IgAN. Methods: First,a retrospective cohort study of 353 IgAN patients was conducted to explore the relationship between uric acid (UA) and the progression of renal disease over a mean period of 5 years. Then, 40 hyperuricemic IgAN patients were randomized to receive allopurinol (100–300 mg/day) or usual therapy for 6 months. The study outcomes were renal disease progression and/or blood pressure. Results: Hyperuricemia independently predicted renal survival at 1, 3, and 5 years after adjustment for different baseline estimated glomerular filtration rates. In the randomized controlled trial, allopurinol did not significantly alter renal progression or proteinuria. The antihypertensive drug dosage was reduced in 7 of 9 cases with hypertension in the allopurinol group compared to 0 of 9 cases in the control group (p < 0.01). UA levels correlated with mean arterial pressure in normotensive patients (r = 0.388, p < 0.001). Conclusion: Hyperuricemia predicts the progression of IgAN independently of baseline estimated glomerular filtration rate. Allopurinol may improve the control of blood pressure. Further studies are required to explore the effects of lowering UA on renal protection in IgAN.

© 2011 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 03, 2011
Accepted: August 03, 2011
Published online: November 23, 2011
Issue release date: April 2012

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 4

ISSN: 1420-4096 (Print)
eISSN: 1423-0143 (Online)

For additional information: https://www.karger.com/KBR


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