Uric Acid and the Endothelium in CKD

Is Uric Acid a Mediator of Endothelial Dysfunction in Patients With Chronic Kidney Disease?

This study will test the hypothesis that uric acid impairs the function of vessels in patients with kidney disease

The purpose of the study is to understand the effect of lowering serum uric acid levels on vascular function in individuals with chronic kidney disease by comparing the effects of:

1) Allopurinol therapy and 2) Placebo.

Patients will receive: 3 month study drug (either allopurinol or placebo), with assessment of serum uric acid levels and vascular function.

Inclusion Criteria:

• Individuals with moderate chronic kidney disease (CKD stage III) with estimated glomerular filtration rates between 30-60 mL/min/ 1.73m2
• Elevated uric acid levels
• Age range: more than 18 years old
• Ability to give informed consent
• Albumin > 3.0 g/dL
• BMI < 40 kg/m2

Exclusion Criteria:

• Life expectancy < 1.0 years
• Expected to undergo living related kidney transplant in 6 months
• Pregnant, breast feeding, or unwilling to use adequate birth control
• History of severe liver disease
• History of severe congestive heart failure
• History of hospitalizations within 3 months
• Active infection, on antibiotics
• History of Warfarin Use or other medications that are contraindicated with allopurinol
• Uncontrolled hypertension
• History of acute gout on Allopurinol
• History of adverse reaction to Allopurinol
• Immunosuppressive therapy within the last 1 yr