Evidence map›Paper›PMID 25928556›Full record

SynthesisBMC nephrology2015

Urate lowering therapy to improve renal outcomes in patients with chronic kidney disease: systematic review and meta-analysis.

Tahir Kanji, Mandark Gandhi, Catherine M Clase, Robert Yang

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC nephrology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06525974 (Clinical Study to Evaluate the Possible Efficacy and Safety of Febuxostat in Patients With Ulcerative Colitis Treated With Mesalamine), which is not on this map. Cited by 70 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 9 pooled it
14.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06525974 early_phase1not yet recruitingnot on this mapstarted 2024, after this paper: background citation

Clinical Study to Evaluate the Possible Efficacy and Safety of Febuxostat in Patients With Ulcerative Colitis Treated With Mesalamine

TypeinterventionalSponsorTanta UniversityRan2024 to 2026Enrolled46ConditionsUlcerative ColitisArmsFebuxostat, Mesalamine
3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 9 syntheses or guidelines pooled it, 176 citations in OpenAlex.

  1. Pooled it
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  15. Article
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  17. Efficacy and Safety of Allopurinol on Chronic Kidney Disease Progression: A Systematic Review and Meta-Analysis.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024
    Article
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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Tahir KanjiMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada. tahir.kanji@medportal.ca.
Mandark GandhiMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada. mandark.gandhi@medportal.ca.
Catherine M ClaseDepartment of Medicine, Division of Nephrology, McMaster University, Hamilton, Ontario, Canada. clase@mcmaster.ca.
Robert YangDepartment of Medicine, Division of Nephrology, McMaster University, Hamilton, Ontario, Canada. ryang@mcmaster.ca.
McMaster University · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

backgroundHyperuricemia may contribute to renal injury. We do not know whether use of treatments that lower urate reduce the progression of chronic kidney disease (CKD) and cardiovascular disease. We performed a systematic review and meta-analysis of randomized controlled trials to assess the benefits and risks of treatments that lower urate in patients with stages 3-5 CKD.

methodsWe searched MEDLINE, EMBASE, CENTRAL, Web of Science and trial registers for randomized controlled trials (RCTs) without language restriction. Two authors independently screened articles, assessed risk of bias and extracted data. Data obtained included serum uric acid, serum creatinine or other estimates of glomerular filtration rate, incidence of end-stage renal disease (ESRD), systolic and diastolic blood pressure, proteinuria, cardiovascular disease and adverse events.

resultsFrom the 5497 citations screened, 19 RCTs enrolling 992 participants met our inclusion criteria. Given significant heterogeneity in duration of follow-up and study comparators, only trials greater than 3 months comparing allopurinol and inactive control were meta-analyzed using random effects models. Pooled estimate for eGFR was in favour of allopurinol with a mean difference (MD) of 3.2 ml/min/1.73 m(2), 95% CI 0.16-6.2 ml/min/1.73 m(2), p = 0.039 and this was consistent with results for serum creatinine. Statistically significant reductions in serum uric acid, systolic and diastolic blood pressure were found, favouring allopurinol. There were insufficient data on adverse events, incidence of ESRD and cardiovascular disease for analysis.

conclusionsAdequately powered RCTs are needed to establish whether treatments that lower urate have beneficial renal and cardiovascular effects.

Indexed as

Cardiovascular DiseasesCreatinineDisease ProgressionGlomerular Filtration RateGout SuppressantsHumansHyperuricemiaKidney Failure, ChronicRenal Insufficiency, ChronicTreatment OutcomeUric AcidUricosuric AgentsCreatinineGout SuppressantsUric AcidUricosuric Agents

Identifiers

PMID25928556
PMCPMC4431373
OpenAlexW2073927954

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.