Abstract
Introduction: Chronic kidney disease (CKD) is a disabling disease with multiple complications, like, increased serum levels of uric acid due to glomerular filtration rate (GFR) impairment. Objectives: This study was designed to evaluate the effect of allopurinol on metabolic acidosis in patients with renal failure. Patients and Methods: This is a randomized controlled-trial study on 50 patients with CKD stage II-IV, who referred to Qaem and Montaserieh hospitals in Mashhad. Patients were selected and randomly divided into two equal groups of 25 subjects. In addition to standard treatments, the intervention group received 100 mg allopurinol tablet for three months and the control group received placebo. Demographic data were obtained from each individual. Serum uric acid level, creatinine, blood pH and bicarbonate levels were assessed at the initiation of treatment and at the end of the third month. Results: The mean age of patients was 54.04±12.62 years. Allopurinol administration resulted in a significant increase of serum bicarbonate levels and pH (P<0.001 for each) compared to the control group. A significant reduction in uric acid (P<0.05) and an increase in GFR (P<0.05) was observed in both groups. Conclusion: Allopurinol could ameliorate metabolic acidosis, glomerular filtration and uric acid in patients with CKD.
Highlights
Chronic kidney disease (CKD) is a disabling disease with multiple complications, like, increased serum levels of uric acid due to glomerular filtration rate (GFR) impairment
Patients were included in the study if they were within the age range of 18 to 80 years, with the diagnosis CKD, hyperuricemia and metabolic acidosis
Intervention resulted in a significant reduction in serum uric acid (P < 0.001), and a significant increase in serum bicarbonate, pH (P < 0.001 for each variable) and GFR (P = 0.002) in the allopurinol administered group
Summary
Chronic kidney disease (CKD) is a disabling disease with multiple complications, like, increased serum levels of uric acid due to glomerular filtration rate (GFR) impairment. Objectives: This study was designed to evaluate the effect of allopurinol on metabolic acidosis in patients with renal failure. Allopurinol administration resulted in a significant increase of serum bicarbonate levels and pH (P < 0.001 for each) compared to the control group. A significant reduction in uric acid (P < 0.05) and an increase in GFR (P < 0.05) was observed in both groups. Conclusion: Allopurinol could ameliorate metabolic acidosis, glomerular filtration and uric acid in patients with CKD. CKD presents with reducing the renal function with or without azotaemia or kidney damage for more than three months [1,2]. Increased serum uric acid levels are commonly seen in CKD patients [3].
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