a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China.
Ren Fail. 2018 Nov;40(1):289-297. doi: 10.1080/0886022X.2018.1456463.
Whether uric acid levels were associated with the progression of chronic kidney disease (CKD) remained controversial. This meta-analysis was aimed to assess the effect of lowering serum uric acid therapy on the progression of CKD to clarify the role of uric acid in the progression of CKD indirectly.
Pubmed, Embase, the Cochrane library, CBM were searched for randomized controlled trials (RCTs) that assessed the efficiency of lowering serum uric acid therapy on the progression of CKD without language restriction. Summary estimates of weighted mean differences (WMDs) and relative risk (RR) were obtained by using random-effect or fixed-effect models. Sensitivity analyses were performed to identify the source of heterogeneity.
A total of 12 randomized controlled trials with 832 CKD participants were included in the analysis. Pooled estimate for eGFR was in favor of lowering serum uric acid therapy with a mean difference (MD) of 3.88 ml/min/1.73 m, 95% CI 1.26-6.49 ml/min/1.73 m, p = .004 and this was consistent with results for serum creatinine. The risk of worsening of kidney function or ESRD or death was significantly decreased in the treatment group compared to the control group (RR 0.39, 95% CI 0.28-0.52, p< .01).
Uric acid-lowering therapy may be effective in retarding the progression of CKD. Further randomized controlled trials should be performed to confirm the effect of lowering serum uric acid therapy on the progression of CKD.
血尿酸水平与慢性肾脏病（CKD）进展之间的关系仍存在争议。本荟萃分析旨在评估降低血清尿酸治疗对 CKD 进展的影响，从而间接阐明尿酸在 CKD 进展中的作用。
检索 Pubmed、Embase、Cochrane 图书馆和 CBM 数据库，以评估降低血清尿酸治疗对 CKD 进展的疗效，不限制语言。使用随机效应或固定效应模型获得加权均数差（WMD）和相对风险（RR）的汇总估计值。进行敏感性分析以确定异质性的来源。
共纳入 12 项随机对照试验，共 832 名 CKD 患者纳入分析。eGFR 的汇总估计值有利于降低血清尿酸治疗，平均差异（MD）为 3.88ml/min/1.73m，95%置信区间（CI）为 1.26-6.49ml/min/1.73m，p=0.004，这与血清肌酐的结果一致。与对照组相比，治疗组肾功能恶化、ESRD 或死亡的风险显著降低（RR 0.39，95%CI 0.28-0.52，p<0.01）。
降低尿酸治疗可能有效延缓 CKD 的进展。应进一步开展随机对照试验，以证实降低血清尿酸治疗对 CKD 进展的影响。
