Febuxostat Improves Uric Acid Levels and Renal Function in Patients with Chronic Kidney Disease and Hyperuricemia: A Meta-Analysis

Abstract

Background. Uric acid nephropathy, also known as hyperuricemia nephropathy or gouty nephropathy, is characterized by uric acid crystal deposition and inflammatory cell infiltration. Herein, we aimed to demonstrate the role of febuxostat on uric acid levels and renal function in patients with chronic kidney disease and hyperuricemia. Methods. Eight databases included were searched for clinical randomized controlled trials. Meanwhile, the confidence interval (CI) of either relative risk or mean difference was set to 95%. Besides, the heterogeneity of the research results is tested by $I^2$ . Results. Ten studies were ultimately included in this meta-analysis. All of them were considered to be random controlled trials. 10 studies reported the serum uric acid of the test group and the control group, which was significantly lower (SMD: -146.44, 95% Cl: -195.96, -86.93, and $P<0.01$ ) than the control group, EGFR (SMD: 3.21, 95% Cl: 1.17, 5.25, and $P<0.01$ ), serum creatinine (SMD: -15.27, 95% Cl: -20.75, -9.79, and $P<0.01$ ), serum urea nitrogen (SMD: -2.37, 95% Cl: -3.31, -1.61, and $P<0.01$ ), and adverse reactions (OR: 0.74, 95% Cl: 0.32, 1.68, and $P=0.47$ ). Conclusion. The results of this study suggest that febuxostat may be effective in patients with CKD with HUA, as evidenced by serum uric acid, creatinine, urea nitrogen, and EGFR. However, large sample, multicenter, low risk of bias clinical studies, as well as basic medical research, are needed.