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Uric acid as a target of therapy in CKD
Diana I Jalal1, Michel Chonchol, Wei Chen
1Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Denver, CO 80045, USA. diana.jalal@ucdenver.edu
Insights
Hyperuricemia, or high uric acid levels, is linked to chronic kidney disease (CKD) progression. Lowering uric acid may protect kidneys and slow CKD development.
Area of Science:
- Nephrology
- Urology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) prevalence is rising globally, leading to poor quality of life and high mortality.
- CKD is irreversible, necessitating identification of modifiable risk factors to slow its progression.
- Hyperuricemia is prevalent in CKD patients and linked to kidney disease in observational studies.
Purpose of the Study:
- To critically review experimental evidence linking hyperuricemia to CKD.
- To identify knowledge gaps regarding hyperuricemia and kidney disease.
- To examine studies on the nephroprotective effects of lowering uric acid in CKD patients.
Main Methods:
- Review of experimental studies on hyperuricemia's role in CKD.
- Analysis of observational studies associating hyperuricemia with kidney disease.
- Evaluation of interventional studies on uric acid-lowering therapies for CKD.
Main Results:
- Experimental data suggest mechanisms by which hyperuricemia contributes to CKD development and progression.
- Observational studies show a high prevalence of hyperuricemia in CKD patients.
- Studies are investigating the potential of reducing uric acid levels to protect the kidneys.
Conclusions:
- Hyperuricemia is a significant factor associated with CKD.
- Further research is needed to understand the full impact of hyperuricemia on kidney disease.
- Lowering uric acid may be a potential therapeutic strategy for preventing and slowing CKD progression.
Abstract:
The prevalence of chronic kidney disease (CKD) has increased and will continue to increase in the United States and worldwide. This is alarming considering that CKD is an irreversible condition and patients who progress to chronic kidney failure have reduced quality of life and high mortality rates. As such, it is imperative to identify modifiable risk factors to develop strategies to slow CKD progression. One such factor is hyperuricemia. Recent observational studies have associated hyperuricemia with kidney disease. In addition, hyperuricemia is largely prevalent in patients with CKD. Data from experimental studies have shown several potential mechanisms by which hyperuricemia may contribute to the development and progression of CKD. In this article, we offer a critical review of the experimental evidence linking hyperuricemia to CKD, highlight gaps in our knowledge on the topic as it stands today, and review the observational and interventional studies that have examined the potential nephroprotective effect of decreasing uric acid levels in patients with CKD. Although uric acid also may be linked to cardiovascular disease and mortality in patients with CKD, this review focuses only on uric acid as a potential therapeutic target to prevent kidney disease onset and progression.
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