Effect of allopurinol drug use on GFR and proteinuria in patients with renal transplant recipients (ADOPTR study).
Usalan, O., et al.Transplant Immunology 2022; 72: 101560.
Aims
The aim of this study was to examine the effect of using allopurinol on renal functions in kidney transplant patients.
Interventions
Participants were randomly assigned to receive either allopurinol or placebo.
Participants
245 renal transplant recipients.
Outcomes
The main outcomes were the assessment of uric acid, urinary protein creatinin ratio, the modification of diet in renal diseases (MDRD) and C-reactive protein (CRP).
Follow-up
24 weeks
CET Conclusions
This is a study of a simple intervention in renal transplant recipients but there are significant questions about the methodology. Renal transplant recipients were randomised to receive either 300mg allopurinol once daily, or placebo, with 6 months follow up. Unfortunately, there is no description of the method of randomisation, so this cannot be assessed. Also, there is no description of how the placebo was designed or administered and whether there was sufficient blinding of patients or investigators. There is no power calculation, nor declaration which was the primary outcome set in advance of the study commencing. The study found that taking allopurinol daily for 24 weeks, was associated with a significant reduction in plasma uric acid level, as one might expect. It was also associated with improved urine albumin:creatinine ratio, serum creatinine and eGFR. Despite these apparently significant results, it is not clear that the study was truly randomised, or placebo controlled, and hence questions will remain about the potential for systematic bias affecting the results.
Data analysis
Per protocol analysis
Trial registration
N/A