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Uric acid and chronic kidney disease: new understanding of an old problem

Duk-Hee Kang1, Wei Chen

  • 1Division of Nephrology, Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Center, Seoul, Korea. dhkang@ewha.ac.kr

Seminars in Nephrology
|October 18, 2011
PubMed

Insights

Hyperuricemia, or high uric acid levels, may be a direct cause of chronic kidney disease (CKD) progression. Uric acid-lowering therapy could potentially slow CKD advancement.

Area of Science:

  • Nephrology
  • Urology
  • Metabolic Diseases

Background:

  • An elevated serum uric acid level is frequently observed in patients with chronic kidney disease (CKD).
  • The independent role of uric acid in reducing glomerular filtration rate and increasing kidney disease risk is debated.
  • Recent studies suggest hyperuricemia may be a causative factor in CKD progression, not merely a consequence.

Purpose of the Study:

  • To review epidemiologic, clinical, and experimental evidence on the role of uric acid in CKD development and progression.
  • To discuss the implications of hyperuricemia in the context of the global CKD epidemic.
  • To propose further research into uric acid-lowering therapies for CKD.

Main Methods:

  • Review of epidemiologic studies in healthy and CKD populations.
  • Analysis of clinical data on uric acid levels and renal function.
  • Examination of experimental research investigating uric acid's effects on the kidneys.

Main Results:

  • Epidemiologic studies indicate uric acid independently lowers glomerular filtration rate.
  • Evidence suggests lowering uric acid stabilizes renal function in CKD patients.
  • These findings imply a causative link between hyperuricemia and CKD progression.

Conclusions:

  • Hyperuricemia may play a direct role in the development and worsening of CKD.
  • Uric acid-lowering therapy presents a potential therapeutic strategy for managing CKD.
  • Large randomized clinical trials are needed to confirm the efficacy of uric acid-lowering treatments in slowing CKD progression.

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