A Randomized Controlled Trial of the Effect of Allopurinol on Left Ventricular Mass Index in Hemodialysis Patients

Elaine Rutherford, Sheila Ireland, Kenneth Mangion, Graham A. Stewart, Mark S. MacGregor, Giles Roditi, Rosemary Woodward, Stephen J. Gandy, J. Graeme Houston, Alan G. Jardine, Petra Rauchhaus, Miles Witham, Patrick B. Mark, Allan D. Struthers

Research output: Contribution to journalArticlepeer-review

5 Downloads (Pure)

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 regresses LVMI in hemodialysis patients.

Methods: This was a randomized placebo-controlled double-blind multicenter trial. 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 300mg or placebo after each dialysis session. The primary outcome was change in LVMI - assessed by cardiac magnetic resonance imaging at baseline and 12 months. Secondary outcomes were change in BP, flow mediated dilation (FMD), augmentation indices (Aix) and pulse wave velocity (PWV).

Results: 53 patients, with a mean age of 58, completed the study and had MRI follow up data for analysis. Allopurinol did not regress LVMI - change in LVMI (g/m2): placebo +3.610.4, allopurinol +1.611 p=0.49. Allopurinol had no demonstrable effect on BP, FMD, Aix or PWV.

Conclusions: Compared with placebo, treatment with allopurinol did not regress LVMI in this trial.
Original languageEnglish
Pages (from-to)146-155
Number of pages10
JournalKidney International Reports
Volume6
Issue number1
Early online date23 Oct 2020
DOIs
Publication statusPublished - 1 Jan 2021

Keywords

  • allopurinol
  • hemodialysis
  • randomized controlled trial
  • left ventricular mass
  • magnetic resonance imaging

Fingerprint Dive into the research topics of 'A Randomized Controlled Trial of the Effect of Allopurinol on Left Ventricular Mass Index in Hemodialysis Patients'. Together they form a unique fingerprint.

Cite this