Table 1 Basic characteristics of included studies
Study | Nation | Sample size | population | Diabetes mellitus —no. (%) | Baseline SUA (μmol/L) | SUA after follow-up(μmol/L) | |||
|---|---|---|---|---|---|---|---|---|---|
I | C | I | C | I | C | ||||
Goicoechea (2012)[12] | Spain | 113 | CKD stage 3–5 | 20 (36) | 22(39) | 470.05 ± 124.95 | 434.35 ± 95.20 | 360 ± 71.4 | 446.25 ± 101.15 |
Badve (2020)[14] | Australia | 363 | CKD stage 3–4 with UCR ≥ 265 mg/g, eGFR decrease ≥ 3.0 ml/min/1.73m2 the preceding year | 104 (57) | 106 (59) | 487.90 ± 107.10 | 487.9 ± 101.15 | 320 [95% CI, 300 -330] | 490[95% CI, 470—500] |
Kimura (2018)[15] | Japan | 441 | CKD stage 3 with Asymptomatic hyperuricemia | 64(29.2) | 68 (30.6) | 464.10 ± 53.55 | 464.1 ± 53.55 | 249.9 [95%CI,238–261.8] | NA |
Golmohammadi (2017)[29] | Iran | 196 | CKD stage 3 with SUA ≥ 360 μmol/L CKD stage 4 with SUA ≥ 360 μmol/L | 35 (36.5) | 44 (44) | 467.67 ± 80.92 | 458.15 ± 74.97 | CKD stage 3 366.52 ± 85.68 CKD stage 4 378.42 ± 79.73 | CKD stage 3 418.28 ± 76.16 CKD stage 4 444.46 ± 86.87 |
Siu (2006)[36] | China | 51 | Daily proteinuria ≥ 0.5 g and/or an elevated serum creatinine(Cr) ≥ 120 µmol/L | 6(24) | 7(27) | 580.12 ± 70.21 | 590.24 ± 99.96 | 349.86 ± 60.01 | 599.76 ± 99.96 |
Tan (2011)[32] | China | 140 | CKD stage 3–4, T2DM, with SUA 420 ~ 600 μmol/L(male),360 ~ 600 μmol/L(female) and daily proteinuria > 0.5 g | 72(100) | 68(100) | 531.23 ± 57.31 | 511.90 ± 60.32 | 330.13 ± 37.65 | 513.46 ± 59.09 |
Zhou (2009)[13] | China | 98 | CKD stage 3–4, with SUA > 420 μmol/L(male),SUA > 360 μmol/L(female).proteinuria > 0.5 g | 16(31.4) | 21(25.5) | 420 ± 36 | 422 ± 50 | 347 ± 34 | 419 ± 51 |
Liu (2007)[37] | China | 47 | Scr level 120 ~ 400 μmol/L with SUA > 420 μmol/L(male),SUA > 350 μmol/L(female) | NA | NA | 579.1 ± 11.7 | 590.5 ± 15.5 | 348.7 ± 12.1 | 598.6 ± 16.7 |
Jalal (2017)[17] | USA | 80 | stage 3 CKD on the basis of Modification of Diet in Renal Disease (MDRD) eGFR of 30–59 ml/min per 1.73m2, had elevated serum uric acid levels (defined as 7.0 mg/dl for men and 6.0 mg/dl for women) | 23 (61) | 25 (61) | 493.85 ± 83.30 | 517.65 ± 95.20 | Change from baseline according to treatment192.78 ± 80.33 | Change from baseline according to treatment2.98 ± 91.63 |
Deng (2010)[35] | China | 61 | Scr level 133 ~ 442 μmol/L with SUA 420 ~ 600 μmol/L(male). 360 ~ 600 μmol/L(female) | 8(27.6) | 13(40.6) | 511.48 ± 60. 31 | 531.47 ± 57.13 | 329.86 ± 38. 16 | 513.56 ± 65.74 |
Lei (2009)[28] | China | 57 | Scr level 133 ~ 442 μmol/L with SUA > 420 μmol/L(male), > 360 μmol/L(female) | NA | NA | 526 ± 86 | 518 ± 84 | 392 ± 67 | 529 ± 72 |
Shi (2012)[16] | China | 40 | IgA nephropathy (IgAN), proteinuria between 0.15 and 2.0 g/24 h with serum albumin level > 3.5 g/dl, Scr < 265.2 μmol/L | NA | NA | 470.05 ± 65.45 | 464.10 ± 65.45 | 339.15 ± 41.65 | 440.30 ± 89.25 |
Sircar (2015)[11] | India | 93 | CKD stages 3–4 with asymptomatic hyperuricemia | 20(44) | 15(31) | 535.5 ± 119.0 | 487.9 ± 65.45 | 309.4 ± 89.25 | 464.10 ± 59.50 |
Mukri (2018)[30] | Malaysia | 93 | CKD stage 3–4 patients with diabetic nephropathy and asymptomatic hyperuricemia(> 404 µmol/L or > 6.8 mg/dl) | 47(100) | 46(100) | 539.5 ± 104.0 | 537.3 ± 70.6 | 331.6 ± 139.8 | 538.7 ± 87.1 |
Shen (2010)[33] | China | 52 | Scr level 133 ~ 442 μmol/L with SUA > 420 μmol/L(male),SUA > 350 μmol/L(female) | NA | NA | 536 ± 82 | 529 ± 89 | 384 ± 72 | 521 ± 78 |
Wen (2019)[31] | China | 38 | CKD stage 3 diabetic nephropathy with serum uric acid ≥ 360 μmol/L | 18(100) | 20(100) | 447.5 ± 83.6 | 423.4 ± 51.2 | 301.2 ± 46.9 | 421.1 ± 55.7 |
Yang (2023)[34] | China | 92 | patients with CKD stages 3 and 4 and asymptomatic hyperuricemia; SUA level ≥ 6.5 mg/dL | 12 (25.5) | 8 (17.8) | 522.6 ± 103.2 | 475.2 ± 53.4 | 337.80 ± 294.6 | 468.0 ± 297.0 |
Study | Basline Kidney function (Scr or eGFR)(μmol/L or mL/min/ 1.73 m2) | Kidney function after follow-up (Scr or eGFR)(μmol/L or mL/min/ 1.73 m2) | Mean age (years) | Therapy | Duration of follow-up | Modified Jadad scores | ||||
|---|---|---|---|---|---|---|---|---|---|---|
I | C | I | C | I | C | I | C | Â | Â | |
Goicoechea(2012)[12] | eGFR 40.6 ± 11.3 | eGFR 39.5 ± 12.4 | eGFR 42.2 ± 13.2 | eGFR 35.9 ± 12.3 | 72.1 ± 7.9 | 71.4 ± 9.5 | Allopurinol 100 mg/d | Usual therapy | 24 monthss | 4 |
Badve (2020)[14] | eGFR 31.6 ± 11.7 | eGFR 31.9 ± 12.4 | Change from baseline according to treatment eGFR slope − 3.33[95% CI, − 4.11 to − 2.55] | Change from baseline according to treatment eGFR slope − 3.23 [95% CI, − 3.98 to − 2.47] | 62.3 ± 12.6 | 62.6 ± 12.9 | Allopurinol 100 mg/d | Placebo | 26 months | 7 |
Kimura (2018)[15] | eGFR 45.2 ± 9.5 | eGFR 44.9 ± 9.7 | eGFR 45.1[95%CI,43.7–46.6] | eGFR 44.3[95% CI, 42.8–45.7] | 65.4 ± 12.3 | 65.3 ± 11.8 | Febuxostat10-40 mg/d | Placebo | 108 weeks | 7 |
Golmohammadi (2017)[29] | CKD stage 3 eGFR 50.37 ± 11.26 CKD stage 4 eGFR 20.84 ± 5.80 | CKD stage 3 eGFR 50.38 ± 13.22 CKD stage 4 eGFR 24.57 ± 3.97 | CKD stage 3 eGFR 56.82 ± 16.53 CKD stage 4 eGFR 27.32 ± 16.4 | CKD stage 3 eGFR 51.99 ± 15.28 CKD stage 4 eGFR27.48 ± 9.85 | NA | NA | Allopurinol 100 mg/d | Placebo | 12 months | 5 |
Siu (2006)[36] | Scr 144.98 ± 55.69 | Scr 164.43 ± 61.00 | Scr 175.92 ± 81.33 | Scr 255.48 ± 84.87L | 47.7 ± 12.9 | 48.8 ± 16.8 | Allopurinol 100 to 300 mg/d | Usual therapy | 12 months | 4 |
Tan (2011)[32] | Scr 228.73 ± 84.60 | Scr 218.27 ± 85.04 | Scr 305.71 ± 140.96 | Scr 399.84 ± 189.26 | 59.3 ± 9.2 | 58.6 ± 8.3 | Allopurinol | No treatment | 6 months | 3 |
Zhou (2009)[13] | eGFR 51.1 ± 13.4 Scr 119 ± 27 | eGFR 50.8 ± 12.7 Scr 118 ± 23 | eGFR 53.8 ± 13.7 Scr 112 ± 22 | eGFR 48.0 ± 11.7 Scr 123 ± 25 | 58.7 ± 8.9 | 59.3 ± 7.8 | Allopurinol 100 to200 mg/d | No treatment | 6 months | 3 |
Liu (2007)[37] | Scr 144.8 ± 22.0 | Scr 158.4 ± 25.0 | Scr 175.7 ± 23.0 | Scr 256.3 ± 51.0 | 45.6 ± 12.5 | 46.5 ± 13.8 | Allopurinol 100 to200 mg/d | No treatment | 12 months | 3 |
Jalal (2017)[17] | CKD stage 3 eGFR 41.3 ± 8.9 | CKD stage 3 eGFR 42.4 ± 9.6 | NA | NA | 55.9 ± 13.7 | 58.9 ± 9.3 | allopurinol100 mg | placebo | 12 weeks | 6 |
Deng (2010)[35] | Scr 217.72 ± 83. 60 | Scr 227.84 ± 87.32 | Scr 303.17 ± 139.69 | Scr 401.00 ± 182.69 | 60.0 ± 11.1 | 58.8 ± 9.4 | Allopurinol 100 to 300 mg/d | No treatment | 12 months | 3 |
Lei (2009)[28] | Scr 238 ± 71 | Scr 242 ± 62 | Scr 227 ± 62 | Scr 293 ± 55 | 48.6 ± 10.2 | 49. 5 ± 9.8 | Allopurinol 100 to 200 mg/d | No treatment | 12 months | 3 |
Shi (2012)[16] | eGFR 69.5 ± 26.5 | eGFR 63.6 ± 27.5 | eGF 73.2 ± 34.8 | eGFR 68.9 ± 36.6 | 39.7 ± 10.0 | 40.1 ± 10.8 | Allopurinol 100 to 300 mg/d | Usual therapy | 6 months | 5 |
Sircar (2015)[11] | eGFR 31.5 ± 13.6 | eGFR 32.6 ± 11.4 | eGFR 33.7 ± 16.6 | eGFR 28.2 ± 11.5 | 56.22 ± 10.87 | 58.42 ± 14.52 | Febuxostat 40 mg /d | Placebo | 6 months | 7 |
Mukri (2018)[30] | eGFR 26.2 ± 14.3 | eGFR 28.2 ± 19.8 | eGFR Mean(IQR) 26.3 (15.2) | eGFR Mean(IQR) 27.6 (20.0) | NA | NA | Febuxostat 40 mg /d | No treatment | 6 months | 4 |
Shen (2010)[33] | Scr 235 ± 72 | Scr 232 ± 62 | Scr 238 ± 65 | Scr 296 ± 58 | 47.1 ± 11.8 | 47.6 ± 12.4 | Allopurinol 100 to 200 mg/d | No treatment | 12 months | 3 |
Wen (2019)[31] | eGFR 45.3 ± 10.6Scr 172.9 ± 20.1 | eGFR 46.8 ± 9.0 Scr 157.7 ± 38.3 | eGFR 53.8 ± 9.6 Scr 148.1 ± 30.2 | eGFR 42.7 ± 13.4 Scr 170.6 ± 51 .9 | 58.73 ± 11.50 | 57.46 ± 10.96 | Febuxostat 20–60 mg /d | No treatment | 24 weeks | 4 |
Yang (2023)[34] | eGFR 29.9 ± 10.8 | eGFR 32.6 ± 8.7 | eGFR Change from baseline according to treatment 0.23 ± 5.26 mL/ min/1.73 m2 /year | eGFR Change from baseline according to treatment 0.47 ± 4.48 mL/min/1.73 m2 /year | 57.0 ± 13.6 | 56.1 ± 13.2 | Febuxostat 20–80 mg /d | routine medical care without uric acid lowering agents | 12 months | 7 |