AI Article Synopsis
- Gout affects over 9 million Americans and is linked to hyperuricemia, which is also common in the 14% of the US population dealing with chronic kidney disease (CKD).
- Recent studies show mixed results about hyperuricemia's role in advancing CKD, and current evidence does not support treating asymptomatic hyperuricemia in these patients.
- The management of gout in patients with CKD or kidney transplant recipients is complex due to heightened medication toxicity risks, and greater nephrologist involvement in treatment is recommended.
Article Abstract
Gout, a debilitating inflammatory arthritis, currently affects more than 9 million Americans. Hyperuricemia, the laboratory abnormality associated with the development of gout, also occurs in a significant number of patients with chronic kidney disease (CKD), a condition that affects approximately 14% of the US population. Several recent studies have attempted to provide a definitive link between the presence of hyperuricemia and progression of CKD; however, the treatment of asymptomatic hyperuricemia in CKD is not supported by recent randomized controlled trials. The pharmacology of acute gout flares and urate lowering is complicated in patients who also have evidence of CKD, primarily because of an increased risk of medication toxicity. Recipients of kidney transplants are particularly at risk of debilitating gout and medication toxicity. We review the available data linking CKD, gout, and hyperuricemia, providing practice guidelines on managing gout in CKD patients and kidney transplant recipients. We advocate for much greater involvement of nephrologists in the management of gout in renal patients.
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| http://dx.doi.org/10.1016/j.semnephrol.2020.12.007 | DOI Listing |
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