Management of Hyperuricemia in Patients with Chronic Kidney Disease: a Focus on Renal Protection.

Abstract:

PURPOSE OF REVIEW:In chronic kidney disease (CKD), plasma uric acid levels are increased because of the decrease in glomerular filtration rate. However, in addition to CKD, hyperuricemia is frequently associated with a number of other conditions such as hypertension, type 2 diabetes, obesity, and heart failure, overweight, and cardiovascular disease. RECENT FINDINGS:It is now becoming increasingly clear that, in many clinical conditions, elevated levels of uric acid have a much greater role beyond just causing gout. The present review will summarize current knowledge on the relation between hyperuricemia, CKD, and existing comorbidities, as well as the mechanisms of uric acid-related renal damage. In addition, the role and evidence for urate-lowering therapy in prevention and cardiovascular protection in CKD patients is discussed with a focus on allopurinol and febuxostat. To date, several clinical studies have provided evidence that urate-lowering therapy may help to prevent and delay the decline of renal function in patients with CKD. Use of a xanthine oxidase inhibitor should be considered in patients who are at high renal risk and/or with declining renal function in the presence of hyperuricemia with and without deposition, although additional studies are warranted to define treatment targets. Notwithstanding, the possibility to delay deterioration of renal function in patients with CKD merits consideration.

journal_name

Curr Hypertens Rep

authors

Kielstein JT,Pontremoli R,Burnier M

doi

10.1007/s11906-020-01116-3

subject

Has Abstract

pub_date

2020-10-31 00:00:00

pages

102

issue

12

eissn

1522-6417

issn

1534-3111

pii

10.1007/s11906-020-01116-3

journal_volume

22

pub_type

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