title: Urate reduction and renal preservation: what is the evidence?
abstract: Hyperuricemia is common among chronic kidney disease (CKD) patients. Experimental evidence suggests that uric acid itself may harm patients with CKD by contributing to CKD progression. Although controversial, these observations are supported by many large observational studies indicating that increased serum uric acid level predicts the development and progression of CKD in a variety of populations. Interventional studies also suggest that reducing uric acid levels in asymptomatic hyperuricemic patients with CKD is safe and might slow CKD progression. However, these studies are limited in scope and have included a relatively small number of participants. Thus, although these data suggest treating asymptomatic hyperuricemia, further studies are needed before we can advise reducing uric acid levels in patients with CKD.
authors.affiliation: Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, C/Dr Esquerdo 46, 28007, Madrid, Spain.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Macías
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.forename: M S García
authors.initials: MS
authors.lastname: de Vinuesa
authors.forename: Ursula
authors.initials: U
authors.lastname: Verdalles
authors.forename: Jose
authors.initials: J
authors.lastname: Luño
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D018450:Disease Progression; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D033461:Hyperuricemia / Q000150:complications* / Q000188:drug therapy*; D051436:Renal Insufficiency, Chronic / Q000209:etiology* / Q000517:prevention & control; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
chemical_list: D004791:Enzyme Inhibitors; D000493:Allopurinol; D014969:Xanthine Oxidase