Journal
DIAGNOSTICS
Volume 11, Issue 9, Pages -Publisher
MDPI
DOI: 10.3390/diagnostics11091674
Keywords
hyperuricemia; gout; chronic kidney disease; xanthine oxidase inhibitor; allopurinol; febuxostat
Categories
Funding
- Chang Gung Memorial Hospital [CORPG5J0031]
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Research has shown the close relationship between hyperuricemia, gout, and renal disease, with various mechanisms explaining the interactions between them. Urate-lowering therapy has been proven to slow down the progression of renal disease in patients with hyperuricemia and gout.
The relationship between hyperuricemia, gout, and renal disease has been investigated for several years. From the beginning, kidney disease has been considered a complication of gout; however, the viewpoints changed, claiming that hypertension and elevated uric acid (UA) levels are caused by decreased urate excretion in patients with renal impairment. To date, several examples of evidence support the role of hyperuricemia in cardiovascular or renal diseases. Several mechanisms have been identified that explain the relationship between hyperuricemia and chronic kidney disease, including the crystal effect, renin-angiotensin-aldosterone system activation, nitric oxide synthesis inhibition, and intracellular oxidative stress stimulation, and urate-lowering therapy (ULT) has been proven to reduce renal disease progression in the past few years. In this comprehensive review, the source and physiology of UA are introduced, and the mechanisms that explain the reciprocal relationship between hyperuricemia and kidney disease are reviewed. Lastly, current evidence supporting the use of ULT to postpone renal disease progression in patients with hyperuricemia and gout are summarized.
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