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Pediatr Nephrol. 2018 Aug;33(8):1405-1409. doi: 10.1007/s00467-018-3943-1. Epub 2018 Mar 16.

Effect of allopurinol on the glomerular filtration rate of children with chronic kidney disease.

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Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Pediatrics, Division of Nephrology, Rush University Medical left, 445 East North Water Street, Suite 1804, Chicago, IL, USA.



Hyperuricemia is a leading risk factor for the development of chronic kidney disease (CKD). We hypothesized that lowering serum uric acid (SUA) with allopurinol in hyperuricemic children with CKD may reduce the risk of CKD progression.


A total of 70 children, aged 3-15 years, with elevated serum uric acid level (SUA) > 5.5 mg/dL and CKD stages 1-3 were prospectively randomized to receive allopurinol 5 mg/kg/day (study group, n = 38) or no treatment (control group, n = 32) for 4 months. The primary and secondary outcomes were changes in estimated glomerular filtration rate (eGFR) (> 10 mL/min/1.73m2) and the SUA (> 1.0 mg/dL) from baseline values, respectively.


Baseline age, gender, blood pressure (BP), body mass index (BMI), SUA, high-sensitive C-reactive protein (hsCRP), and eGFR were similar in allopurinol and control subjects. Allopurinol treatment resulted in a decrease in SUA, a decrease in systolic and diastolic BP, a decrease in hsCRP, and an increase in eGFR compared with the baseline values (p < 0.05 for all). No significant difference was observed in the control hyperuricemic subjects. In multiple regression analysis after incorporating variables (age, gender, BMI, systolic and diastolic BP, CRP, and SUA), eGFR was independently related to SUA both before and after treatments (p = 0.03 vs. p = 0.02, respectively). All patients in the study group tolerated allopurinol, and there were no adverse reactions observed by physical examination or reported by patients.


Urate-lowering therapy with allopurinol, over a 4-month period, can improve renal function in children with CKD stages 1-3.


Allopurinol; Children; Chronic kidney disease; High-sensitive C-reactive protein; Hyperuricemia

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