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Management of gout in chronic kidney disease: a G-CAN Consensus Statement on the research priorities

Lisa K Stamp1, Hamish Farquhar2, Huai Leng Pisaniello3

  • 1University of Otago, Christchurch, New Zealand. Lisa.Stamp@cdhb.health.nz.

Nature Reviews. Rheumatology
|July 31, 2021
PubMed

Insights

Managing gout in patients with chronic kidney disease (CKD) is challenging due to limited evidence and conflicting recommendations. This consensus statement highlights research gaps for effective gout and CKD management.

Area of Science:

  • Nephrology
  • Rheumatology
  • Clinical Pharmacology

Background:

  • Gout and chronic kidney disease (CKD) frequently coexist, creating management challenges.
  • Current evidence guiding gout management in CKD patients is limited, leading to varied treatment approaches.
  • Conflicting professional recommendations exacerbate confusion among clinicians regarding gout and CKD treatment.

Framework:

  • This consensus statement by the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) analyzes existing evidence on gout management in CKD.
  • It identifies critical research gaps concerning both general management strategies and specific urate-lowering therapies (ULTs) and flare treatments.
  • The statement is supported by G-CAN systematic literature reviews, focusing on safety and efficacy data.

Implementation:

  • The document critically examines the use of urate-lowering therapy (ULT) in advanced CKD.
  • It discusses the safety and efficacy of various medications used for gout flares and ULT.
  • Key areas for future research are identified to address the lack of robust evidence.

Implications:

  • Clarifies the current state of knowledge regarding gout management in CKD patients.
  • Provides a research agenda to guide future studies on optimal treatment strategies.
  • Aims to reduce clinical confusion and improve patient care for those with coexisting gout and CKD.

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