Uric acid: a novel mediator and marker of risk in chronic kidney disease?
OBJECTIVE
To assess the current data suggesting that uric acid-lowering therapy may be useful in the prevention or mitigation of chronic kidney disease (CKD).


RESULTS
Eleven observational studies assessing the potential role of serum uric acid in the prevalence and progression of CKD have been published in the past 2 years. Seven suggest an association, whereas four do not. Recent experimental models and clinical trials have mechanistically linked serum uric acid and hypertension, an established risk factor for CKD.


CONCLUSIONS
Elevated serum uric acid is a marker for decreased renal function, may have a mechanistic role in the incidence and progression of renal functional decline and likely has a causal role in hypertension and vascular disease. Clinical trials are needed to determine whether uric acid-lowering therapy will be effective in preventing CKD.
Feig
Daniel I
DI
Baylor College of Medicine and Texas Children's Hospital, Houston, Texas 77030, USA. dfeig@bcm.edu
D000818:Animals; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology; D033461:Hyperuricemia / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007674:Kidney Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D014527:Uric Acid / Q000097:blood*
D015415:Biomarkers; D014527:Uric Acid