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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The renal effects of urate-lowering therapy remain controversial in patients with chronic kidney disease (CKD), particularly for selective urate reabsorption inhibitors (SURI). Dotinurad, a novel SURI, has shown potent uricosuric effects by selectively inhibiting the urate transporter 1 (URAT1). However, comparative data with xanthine oxidase inhibitors (XOI) regarding kidney function trajectories are limited. This study aimed to compare changes in the estimated glomerular filtration rate (eGFR) slope between patients initiating dotinurad and those initiating febuxostat, the most widely used XOI.
This retrospective cohort study included 81 CKD patients with hyperuricemia (31 on dotinurad, 50 on febuxostat) treated at a single center in Japan. All available eGFR measurements from 12 months before to 12 months after treatment initiation were analyzed using a linear mixed-effects model with random intercepts and slopes. The model included group (dotinurad vs febuxostat), period (pre- vs post-treatment), and time (in years) as fixed effects, along with their interactions. Covariates included baseline eGFR, uric acid, age, sex, hypertension, diabetes, use of renin–angiotensin system inhibitors (RASi), sodium–glucose cotransporter 2 inhibitors (SGLT2i), and loop diuretics. The primary outcome was the three-way interaction term (group × period × time), representing the difference-in-differences in eGFR slope change.
At baseline, the median eGFR was 46.8 ml/min/1.73 m² and median serum uric acid was 8.6 mg/dl. During the pre-treatment period (−12 to 0 months), the annual eGFR slope was −2.8 ml/min/1.73 m²/year in the dotinurad group and −0.3 ml/min/1.73 m²/year in the febuxostat group, with a non-significant group × time interaction (p = 0.086). After treatment initiation (0 to +12 months), the slopes diverged (+1.4 vs −0.8 ml/min/1.73 m²/year). In the multivariable linear mixed-effects model, the three-way interaction term (group × period × time) was statistically significant (p = 0.048), indicating a greater improvement in eGFR slope in the dotinurad group. The within-group change in eGFR slope (post minus pre) was +4.2 ml/min/1.73 m²/year for dotinurad (p = 0.021) and −0.5 ml/min/1.73 m²/year for febuxostat (p = 0.731).
In this real-world cohort of CKD patients with hyperuricemia, initiation of dotinurad was associated with a significantly greater improvement in kidney function slope compared with febuxostat, even after adjustment for major confounders. These findings suggest that dotinurad, a selective urate reabsorption inhibitor, may confer renal benefits distinct from xanthine oxidase inhibitors, supporting the importance of the mechanism of urate lowering in CKD management
