Elevated levels of serum urate mark the progression of chronic kidney disease. Allopurinol is a urate-lowering treatment that is believed to be effective in declining the progression of the disease. This study aims to evaluate the effectiveness of allopurinol on the progression of chronic kidney disease.

This is a randomized, controlled trial conducted on a total of 369 adults with stage or 4 kidney disease. The participants were divided into two equal groups; one group (n=185) received allopurinol, and the other group (n=184) received a placebo. The main outcome of the trial was a change in estimated glomerular filtration rate (eGFR) from randomization to week 104. 

Three participants from each group withdrew immediately after randomization. Among the remaining 363 patients, there was no significant difference in eGFR change between the allopurinol and placebo group. Severe adverse events occurred in 84 patients (46%) of the allopurinol group and 79 patients (44%) in the placebo group.

The research concluded that urate-lowering treatment with allopurinol did not slow down the decline in eGFR in patients at a high risk of progression of chronic kidney disease. The occurrence of adverse effects was also comparable in both groups.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1915833