Uric Acid and the Endothelium in CKD

Not Applicable

Completed

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

Detailed Description: 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.

Recruitment & Eligibility

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

Arm && Interventions

Group	Intervention	Description
Control	Placebo	Patients who are randomized to this group will received placebo tablets. Placebo tables do not contain an active ingredient. This group will be used as a baseline group to compare the effects of lowering uric acid on vascular function.
Allopurinol	Allopurinol	Patients who are randomized to this group will receive allopurinol tablets. Allopurinol is a medicine that lowers uric acid levels. The effects of lowering uric acid on vascular function outcomes will be assessed and compared to the control group.

Primary Outcome Measures

Name	Time	Method
Change in Endothelial Dependent Dilation From Baseline to Week 12	Baseline and 12 weeks	Change in Endothelial Dependent Dilation measured by Flow Mediated Dilation at baseline and week 12

Secondary Outcome Measures

Name	Time	Method
Change in C-reactive Protein From Baseline to Week 12	Baseline and 12 weeks
Change in Oxidized Low Density Lipoprotein From Baseline to Week 12	Baseline and 12 weeks
Change in Serum Interleukin-6 From Baseline to Week 12	Baseline and 12 weeks
Change in Monocyte Chemotactic Protein-1 From Baseline to Week 12	Baseline and 12 weeks