Chronic kidney disease (CKD) is a prevalent condition associated with various comorbidities, including hyperuricemia (HUA), which contributes to kidney function decline. Urate-lowering treatments have been explored to mitigate the detrimental effects of hyperuricemia on renal function. Hyperuricemia (HUA) is a noncommunicative disease whose prevalence has rapidly increased overtime. Hyperuricemia causes gout, including gouty arthritis, and also increases the risk of kidney dysfunction or chronic kidney disease (CKD).

A recent study, researchers investigated the potential benefits of dotinurad, a novel urate-lowering agent, on renal function in CKD patients with hyperuricemia. This study was published in the journal of BMC Nephrology by Hoichi Amano and colleagues.
The study enrolled 35 CKD patients diagnosed with hyperuricemia, with a mean age of 65.4 years, including 23 men. Patients underwent a 3-month observation period followed by 3 months of treatment with dotinurad. Changes in estimated glomerular filtration rate (eGFR) before and after dotinurad administration were assessed.
The key findings of the study were:
• During the observation period, the mean eGFR declined significantly.
• At baseline, the mean eGFR was 31.8 mL/min/1.73 m², and the serum urate level (sUA) was 8.1 mg/dL.
• However, during the treatment period with dotinurad, the eGFR improved to 36.5 mL/min/1.73 m², and the sUA decreased to 6.7 mg/dL.
• There was a positive correlation between the increase in eGFR after dotinurad administration and the decrease in sUA (R = 0.375, p = 0.0263).
The findings suggest that dotinurad administration in CKD patients with hyperuricemia may have beneficial effects on restoring kidney function. This novel urate-lowering treatment shows promise as a potential medication for preventing kidney function decline associated with hyperuricemia in CKD patients. Further research is warranted to validate these results and explore the long-term effects of dotinurad on renal outcomes.
Reference:
Amano, H., Kobayashi, S., & Terawaki, H. (2024). Dotinurad restores exacerbated kidney dysfunction in hyperuricemic patients with chronic kidney disease. BMC Nephrology, 25(1). https://doi.org/10.1186/s12882-024-03535-9