SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Renal Pharmacology
Febuxostat effectively reduces uric acid but has a limited renoprotective effect on renal transplant recipients with hyperuricemia: a meta-analysis
Sheng Chao
Kejing Zhu
Lei Jia
Yulin Niu
Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Abstract
Objective: Several previous studies have indicated that febuxostat can reduce uric acid (UA) levels and has a renoprotective effect on renal transplant recipients with hyperuricemia, but a comprehensive analysis of this effect is lacking. This meta-analysis aimed to analyze the effects of febuxostat on UA and renal function in renal transplant recipients with hyperuricemic disease. Methods: Web of Science, PubMed, the Cochrane Library, Wan Fang, and CNKI were searched up to October 17, 2024. Results: In renal transplant recipients with hyperuricemia, febuxostat decreased the UA level, with an MD of 129.981 µmol/L (P<0.001). Creatinine (Cr) decreased (P=0.337), whereas the estimated glomerular filtration rate (eGFR) increased, with a mean difference of -1.878 mL/min/1.73 m2, reaching a margin of statistical significance (P=0.075) after the administration of febuxostat. In terms of other biochemical indices, febuxostat increased only hemoglobin (P=0.008) but did not affect white blood cells, aspartate transaminase, or alanine aminotransferase (all P>0.05). Sensitivity analysis revealed that the omission of most studies did not affect the study findings. The quality of the included studies was acceptable, and no publication bias existed. Conclusion: Febuxostat has a satisfactory UA-lowering effect, but its renoprotective effect is uncertain in renal transplant recipients with hyperuricemia. More studies are warranted to further explore its role in improving the prognosis of these patients.
Summary
Keywords
Febuxostat, Hyperuricemia, Meta-analysis, renal transplant, Uric Acid
Received
02 December 2025
Accepted
18 February 2026
Copyright
© 2026 Chao, Zhu, Jia and Niu. 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: Sheng Chao; Yulin Niu
Disclaimer
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