High levels of uric acid are associated with hypertension, inflammation, renal disease progression, and cardiovascular disease. However, no data are available regarding the effect of allopurinol in patients with chronic kidney disease.

Allopurinol helps to reduce levels of uric acid and preliminary studies have shown it have potential in preventing kidney disease. Another advantage of the drug is that it has been used in humans, for the treatment of gout, for around 50 years and therefore its safety is well known and it is cheap.

US researchers are recruiting 500 patients with type 1 diabetes to test if allopurinol delays the onset of kidney disease. If the 42-month study succeeds, the decades-old medication could be to diabetic kidney disease what baby aspirin is to heart attacks, says endocrinologist Dr Luiza Caramori.The drug could delay the need for dialysis and kidney transplants by eight to 10 years, she says. While the University of Minnesota study is limited to subjects with type 1 diabetes, Dr Caramori says positive findings are likely also to benefit people with type 2 diabetes.The study will assign subjects randomly to two equal groups. They will get either allopurinol or a placebo.

Results from three small preliminary studies indicate that allopurinol shows real promise. It suppresses the production of an enzyme, xanthine oxidase, a result of metabolic activity, which can lead to excess acid in the urine. The World Health Organization lists it as an essential medicine for health systems.The allopurinol study is the only kidney disease trial and the only Type 1 diabetes trial that NIH funded this year.