SYSTEMATIC REVIEW article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1657274
Evaluation of Febuxostat in Treating Diabetic Kidney Disease with Hyperuricemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Provisionally accepted
- Changchun University of Chinese Medicine, Changchun, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Diabetic kidney disease (DKD) combined with hyperuricemia (HUA) constitutes a pathological state of vicious cycle, where diabetic microvascular complications affect the kidneys and interact with persistent hyperuricemia. This condition significantly accelerates the progression of renal failure and increases all-cause mortality. Objective: This study aims to systematically evaluate the clinical efficacy and safety of febuxostat in treating patients with DKD and HUA via a meta-analysis, thereby providing evidence-based guidance for optimizing clinical medication. Methods: Following the PICOS principle, we systematically searched for randomized controlled trials (RCTs) on febuxostat for treating DKD combined with HUA, 2 covering the period from the establishment of each database to June 26, 2025. Studies meeting the inclusion criteria were selected, and a meta-analysis was performed using Review Manager 5.4 software. Results: A total of 17 RCTs were included, involving 1300 patients (treatment group n=647, control group n=653). The results of the meta-analysis showed that the overall effective rate of the febuxostat treatment group was significantly higher than that of the control group (RR=1.24, 95%CI: 1.17-1.32; Z=7.17, P<0.001). In addition, febuxostat significantly reduced serum uric acid (SUA), urinary albumin-to-creatinine ratio (UACR), serum creatinine (Scr), and blood urea nitrogen (BUN) levels, and improved the estimated glomerular filtration rate (eGFR) (P<0.001 for all indicators). Conclusion: This meta-analysis indicates that febuxostat, when used to treat patients with DKD and HUA, can significantly enhance overall clinical effectiveness and effectively improve key renal function indicators—including SUA, UACR, Scr, BUN, and eGFR. The results of this study showed that when febuxostat is used to treat patients with diabetic nephropathy complicated by hyperuricemia, it achieves a higher overall clinical response rate. It can significantly reduce the levels of SUA, UACR, Scr, and BUN in patients, while improving the eGFR. Additionally, the incidence of adverse reactions associated with febuxostat is lower, suggesting that this drug exhibits favorable clinical safety.
Keywords: Febuxostat, Hyperuricemia, Diabetic kidney disease, Meta-analysis, randomized controlled trial
Received: 01 Jul 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Lin, Zhang, Wu, Zhao, Nan and Fu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zheng Nan, 15526888662@163.com
Yujuan Fu, fuyujuan1111@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.