Hyperuricemia and chronic kidney disease: to treat or not to treat.
Journal
Jornal brasileiro de nefrologia
ISSN: 2175-8239
Titre abrégé: J Bras Nefrol
Pays: Brazil
ID NLM: 9426946
Informations de publication
Date de publication:
Historique:
received:
16
12
2020
accepted:
28
12
2020
pubmed:
12
3
2021
medline:
17
12
2021
entrez:
11
3
2021
Statut:
ppublish
Résumé
Hyperuricemia is common in chronic kidney disease (CKD) and may be present in 50% of patients presenting for dialysis. Hyperuricemia can be secondary to impaired glomerular filtration rate (GFR) that occurs in CKD. However, hyperuricemia can also precede the development of kidney disease and predict incident CKD. Experimental studies of hyperuricemic models have found that both soluble and crystalline uric acid can cause significant kidney damage, characterized by ischemia, tubulointerstitial fibrosis, and inflammation. However, most Mendelian randomization studies failed to demonstrate a causal relationship between uric acid and CKD, and clinical trials have had variable results. Here we suggest potential explanations for the negative clinical and genetic findings, including the role of crystalline uric acid, intracellular uric acid, and xanthine oxidase activity in uric acid-mediated kidney injury. We propose future clinical trials as well as an algorithm for treatment of hyperuricemia in patients with CKD.
Identifiants
pubmed: 33704350
pii: S0101-28002021005026301
doi: 10.1590/2175-8239-JBN-2020-U002
pmc: PMC8940113
pii:
doi:
Substances chimiques
Uric Acid
268B43MJ25
Types de publication
Journal Article
Langues
eng
por
Sous-ensembles de citation
IM
Pagination
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