The effect of allopurinol on lowering blood pressure in hemodialysis patients with hyperuricemia

Background: hyperuricemia has been associated with the development of high blood pressure (bp). we studied the effects of allopurinol therapy in hyperuricemic hemodialysis (hd) patients with high bp. materials and methods: this single-blind, randomized cross-over clinical study involved 55 hd patients with serum uric acid level > 6.5 (men) and > 5.5 mg/dl (women). they were randomly divided in two groups, each of which went through two phases. group-1 in phase-1 received 100 mg/day orally of allopurinol for three months; while group-2 was given whatever medication they received prior to the study. after two months of washing period, the groups were crossed-over. the bp levels were measured before and after hd during the eight months study period. results: fifty-three patients completed the study (33 men and 20 women, with mean age of 55.8 years). uric acid levels decreased significantly during the12 weeks of allopurinol therapy (7.71 ± 1.53 to 5.2 ± 1.2 p < 0.005). overall, after the 12 weeks of allopurinol therapy, systolic and diastolic bp also significantly decreased in allopurinol group, 15.8% (139 to 117, p < 0.0005) and 8.6% (81 to 74, p < .0005), respectively. there were not significant changes in body mass index, blood urea nitrogen, creatinine, albumin, cholesterol, triglyceride, hemoglobin, liver enzymes and serum electrolytes level after treatment. patients treated with allopurinol had a significant increase in the quality of dialysis (kt/v) (p: 0.043). conclusions: in hd patients, allopurinol treatment reduced bp. the results indicate a new potential therapeutic approach for controlling bp in hd patients.