A widely held belief that lowering elevated blood urate levels might put the brakes on the worsening of kidney disease has been rebutted by Australian-led research.

International studies suggest up to 20% of patients are being prescribed the gout medication allopurinol off-label to slow progression of kidney disease, says Associate Professor Sunil Badve, nephrologist and researcher from the George Institute for Global Health in Sydney.

But a randomised controlled trial he co-led found no significant slowing in the decline in eGFR in patients with chronic kidney disease who were on the drug compared with those on placebo, despite a mean reduction of 35% in serum urate levels.

The researchers drew data from 276 patients with stage 3 or 4 kidney disease, who had no history of gout and who were deemed to be at increased risk of disease progression, from 31 hospitals in Australia and New Zealand.