A randomized, controlled trial of the effect of allopurinol on left ventricular mass index in hemodialysis patients

Rutherford, E. et al. (2021) A randomized, controlled trial of the effect of allopurinol on left ventricular mass index in hemodialysis patients. Kidney International Reports, 6(1), pp. 146-155. (doi: 10.1016/j.ekir.2020.10.025) (PMID:33358501) (PMCID:PMC7590839)

Abstract

Introduction: Increased left ventricular mass index (LVMI) is associated with mortality in end-stage renal disease. LVMI regression may improve outcomes. Allopurinol has reduced LVMI in randomized controlled trials in chronic kidney disease, diabetes, and ischemic heart disease. This study investigated whether allopurinol would regress LVMI in hemodialysis patients. Methods: This was a randomized placebo-controlled double-blind multicenter trial. A total of 80 patients undergoing regular maintenance hemodialysis were recruited from NHS Tayside, NHS Greater Glasgow and Clyde and NHS Ayrshire and Arran in Scotland, UK. Participants were randomly assigned on a 1:1 ratio to 12 months of therapy with allopurinol 300 mg or placebo after each dialysis session. The primary outcome was change in LVMI, as assessed by cardiac magnetic resonance imaging (MRI) at baseline and 12 months. Secondary outcomes were change in BP, flow-mediated dilation (FMD), augmentation indices (AIx), and pulse wave velocity (PWV). Results: A total of 53 patients, with a mean age of 58 years, completed the study and had MRI follow-up data for analysis. Allopurinol did not regress LVMI (change in LVMI: placebo +3.6 ± 10.4 g/m2; allopurinol: +1.6 ± 11 g/m2; P = 0.49). Allopurinol had no demonstrable effect on BP, FMD, AIx, or PWV. Conclusion: Compared with placebo, treatment with allopurinol did not regress LVMI in this trial.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mangion, Dr Kenneth and Rutherford, Dr Elaine and Woodward, Miss Rosemary and Roditi, Dr Giles and Mark, Professor Patrick and Jardine, Professor Alan
• Authors: Rutherford, E., Ireland, S., Mangion, K., Stewart, G. A., MacGregor, M., Roditi, G., Woodward, R., Gandy, S. J., Houston, J. G., Jardine, A., Rauchhaus, P., Witham, M. D., Mark, P. D., and Struthers, A. D.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Kidney International Reports
• Publisher: Elsevier
• ISSN: 2468-0249
• ISSN (Online): 2468-0249
• Published Online: 04 December 2020
• Copyright Holders: Copyright © 2020 International Society of Nephrology
• First Published: First published in Kidney International Reports 6(1): 146-155
• Publisher Policy: Reproduced under a Creative Commons License