TY - JOUR
T1 - A Randomized Controlled Trial of the Effect of Allopurinol on Left Ventricular Mass Index in Hemodialysis Patients
AU - Rutherford, Elaine
AU - Ireland, Sheila
AU - Mangion, Kenneth
AU - Stewart, Graham A.
AU - MacGregor, Mark S.
AU - Roditi, Giles
AU - Woodward, Rosemary
AU - Gandy, Stephen J.
AU - Houston, J. Graeme
AU - Jardine, Alan G.
AU - Rauchhaus, Petra
AU - Witham, Miles
AU - Mark, Patrick B.
AU - Struthers, Allan D.
N1 - Funding Information:
The investigators would like to thank all trial participants and our funders the British Heart Foundation ( PG/12/72/29743 ). This trial would not have been possible without support from the renal clinical research nurses in NHS Greater Glasgow and Clyde and NHS Ayrshire and Arran. This trial was prospectively registered with clinicaltrials.gov (NCT01951404). ER is currently funded by a joint NHS Education for Scotland and Chief Scientist Office Clinical Lectureship (PCL/18/03).
Funding Information:
The investigators would like to thank all trial participants and our funders the British Heart Foundation (PG/12/72/29743). This trial would not have been possible without support from the renal clinical research nurses in NHS Greater Glasgow and Clyde and NHS Ayrshire and Arran. This trial was prospectively registered with clinicaltrials.gov (NCT01951404). ER is currently funded by a joint NHS Education for Scotland and Chief Scientist Office Clinical Lectureship (PCL/18/03). ER recruited patients, arranged follow-up visits, analyzed the study data, and wrote the original manuscript draft. SI assisted with trial management, follow-up visits, and patient recruitment. ER, KM, RW, SJG, GR, and MDW assisted with study data acquisition, safety, and integrity. GAS, MM, and PBM were local site study principal investigators. ADS, PBM, AGJ, and JGH conceived the study and provided senior supervision for the study. MDW assisted with data close-out and study data integrity. PR provided statistical input throughout the planning, conducting, close-out, and analysis phases of the study. All authors contributed to and agreed on the final submitted version of this manuscript and take responsibility for its contents.
Publisher Copyright:
© 2020 International Society of Nephrology
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - 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 funded by the British Heart Foundation (PG/12/72/29743). 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 (CMRI) 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 CMRI follow-up data for analysis. Allopurinol did not regress LVMI (change in LVMI: placebo +3.6 ± 10.4 g/m
2; allopurinol: +1.6 ± 11 g/m
2; 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.
AB - 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 funded by the British Heart Foundation (PG/12/72/29743). 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 (CMRI) 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 CMRI follow-up data for analysis. Allopurinol did not regress LVMI (change in LVMI: placebo +3.6 ± 10.4 g/m
2; allopurinol: +1.6 ± 11 g/m
2; 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.
KW - allopurinol
KW - hemodialysis
KW - randomized controlled trial
KW - left ventricular mass
KW - magnetic resonance imaging
U2 - 10.1016/j.ekir.2020.10.025
DO - 10.1016/j.ekir.2020.10.025
M3 - Article
C2 - 33426394
SN - 2468-0249
VL - 6
SP - 146
EP - 155
JO - Kidney International Reports
JF - Kidney International Reports
IS - 1
ER -
