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Drug used to slow kidney disease found to be ineffective

25 June 2020

A new study conducted by PAH researchers to determine the efficacy of kidney disease treatment Allopurinol has shown the drug is ineffective which will mean just one less medication to be taken by up to 20 per cent of patients.

The CKD-FIX study led by Chief Investigator and Medical Director of the Queensland Renal Transplant Service based at PAH, Professor David Johnson provides the first evidence that the medication has limited effect in treating kidney disease. 

“Our two-year study compared the use of Allopurinol to a placebo and found, to our surprise, that it made no difference to the rate of kidney function decline,” said Professor Johnson who partnered with University of Queensland, Translational Research Institute, and the Australasian Kidney Trials Network.

"Allopurinol was developed to treat gout but has also been used to reduce the progression of chronic kidney disease for almost 20 years based on the belief that it could reduce uric acid in the blood.”

This clinical trial suggests that the level of blood urate is only an indicator of reduced kidney function, not a cause.

“Based on our results we believe there is no benefit in prescribing this medication, unless there is an additional specific medical reason, such as gout.

This much awaited, high-quality evidence will inform global clinical guidelines for patient treatment," Dr Johnson said. 

Kidney transplant patient, Phil Carswell said that treatment for kidney failure is one of the most draining and life-changing experiences you can possibly imagine. 

“You are tied to the dialysis unit for four hours, three times a week and you can’t miss a session, or you will get sick very quickly. You have to take a handful of drugs every day which changes your life from doing what you want to do, to doing what you have to do.”

He said that hospitals strive for good practice and clinical evidence is essential to make sure patients get the best treatment possible.

“Research like this is really important and leads to high-value care.  Patients right around the world will benefit from this research,” Mr Carswell said.

Professor Johnson said it was important that people taking Allopurinol to lower blood urate levels did not abruptly stop the treatment, but first discussed their kidney care management with a doctor.

Approximately 1.7 million Australians and 400,000 New Zealanders aged 18 years and older have chronic kidney disease.

The two-year study, conducted with the Australasian Kidney Trials Network, ran across 31 hospitals in Australia and New Zealand and involved 369 patients with stage 3 or 4 chronic kidney disease and at increased risk of kidney disease progression.

This study was funded by the National Health and Medical Research Council and the Health and Research Council of New Zealand, and published in The New England Journal of Medicine (DOI: 10.1056/NEJMoa1915833).

Last updated 26 June 2020
Last reviewed 26 June 2020

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