LAUSR

OBJECTIVES Despite the preclinical evidence on protective effects of colchicine against kidney fibrosis, whether colchicine could delay the progression of chronic kidney disease (CKD) in humans remains unknown. This study examined the association between long-term colchicine use and risk of adverse kidney outcome in patients with CKD who were treated for hyperuricemia or chronic gout. METHODS We conducted a multicentre, nested, case-control study in three Korean hospitals. Patients were aged ≥ 19 years; had CKD G3-G4; and used drugs including colchicine, allopurinol, and febuxostat for hyperuricemia or chronic gout during April 2000-October 2020. Patients with CKD progression, which was defined as ≥ 40% decrease from the baseline estimated glomerular filtration rate or the onset of kidney failure with replacement therapy, were matched to controls based on follow-up time, age, and sex. RESULTS Overall, 3085 patients with CKD progression were matched to 11715 control patients. Multivariate conditional logistic regression analysis showed that patients with ≥ 90 cumulative daily colchicine doses were associated with a lower risk of CKD progression (adjusted odds ratio [AOR], 0.77; 95% confidence interval [CI], 0.61-0.96) than non-users. In the sensitivity analysis with matched CKD stages, the AOR was 0.77 (95% CI, 0.62-0.97). This association was more pronounced in patients without diabetes or hypertension, and in patients with CKD G3. CONCLUSION Colchicine use is associated with a lower risk of adverse kidney outcomes in CKD patients with hyperuricemia, or chronic gout.