Optimal Administration of Allopurinol in Dialysis Patients

Maisonneuve-Rosemont Hospital

Status and phase: Completed; Phase 4

Conditions: Renal Insufficiency; Gout

Treatments: Drug: Allopurinol

Study type: Interventional

Funder types: Other

Identifiers

NCT02477488

14106 (Other Identifier)

Details and patient eligibility

About

Gout has a strong association with the metabolic syndrome, and it is often seen in patients with renal insufficiency. Allopurinol is a medication intended to lower uric acid and therefore prevents gout attacks. Its metabolism is mainly renal, and some evidence shows that it is also dialyzable. The hypothesis is that allopurinol would be more efficacious to lower uric acid if it was given after dialysis only. The investigators will then switch administration of allopurinol to bedtime for dialysis patients currently taking that medication.

Full description

Gout has a strong association with the metabolic syndrome, and it is often seen in patients with renal insufficiency. A study has shown an incidence of fifteen percent of gout in the first five years spent in dialysis and it was associated with an increased mortality. Allopurinol is a medication intended to lower uric acid and therefore prevents gout attacks. Its metabolism is mainly renal, and some studies from the early 1960s demonstrated that it is also dialyzable. At the moment, we do not have strong evidence of the optimal dosage of allopurinol with modern techniques of dialysis. The hypothesis is that allopurinol would be more efficacious to lower uric acid if it was given after dialysis only. The investigators will then switch administration of allopurinol to bedtime for dialysis patients currently taking that medication. Dosage of uric acid will be performed to assess the efficacy of the intervention.

Enrollment: 50 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Subjects who receive chronic treatments of hemodialysis at Maisonneuve-Rosemont Hospital
• Subjects who take allopurinol for at least a month

Exclusion criteria

• Subjects who have had an acute gout attack in the past month
• Subjects with tumor lysis syndrome
• Sujects who have a history of hypersensitivity reaction to allopurinol
• Subjects with hepatic insufficiency
• Women who are pregnant or planning to become pregnant in the next three months

Trial design

Primary purpose: Prevention

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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50 participants in 1 patient group

Allopurinol HS

Experimental group

Description:

Allopurinol at bedtime compared to AM administration

Treatment:

Drug: Allopurinol