Mitochondrial Oxidative Stress and Vascular Remodeling in Uric Acid Nephropathy: Mechanistic Insights and Therapeutic Implications.

In stage 3 CKD, 12 weeks of allopurinol reduced serum urate by approximately 3.24 ± 1.35 mg/dL but did not significantly change brachial artery flow-mediated dilation (FMD) overall; among nondiabetic participants, FMD showed a nonsignificant trend toward greater improvement. 169 Regarding renoprotection, two large RCTs—CKD-FIX and PERL—did not demonstrate a benefit of urate lowering on the estimated glomerular filtration rate (eGFR) slope: CKD-FIX reported −3.33 vs −3.23 mL/min/1.73 m2 per year for allopurinol versus placebo, and PERL simila

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