Related Experiment Video

Updated: Oct 4, 2025

Using 2-Photon Microscopy to Quantify the Effects of Chronic Unilateral Ureteral Obstruction on Glomerular Processes
11:47

Using 2-Photon Microscopy to Quantify the Effects of Chronic Unilateral Ureteral Obstruction on Glomerular Processes

Published on: March 4, 2022

2.4K

Effect of Urate-Lowering Therapy on the Progression of Kidney Function in Patients With Asymptomatic Hyperuricemia: A

Lin Zhang1, Kang An1, Xingyu Mou1

  • 1Department of General Practice, West China Hospital, Sichuan University, Chengdu, China.

Frontiers in Pharmacology
|February 4, 2022
PubMed

Insights

Urate-lowering therapy (ULT) does not slow kidney function decline in patients with asymptomatic hyperuricemia. While ULT lowers uric acid and gout risk, it did not prevent kidney events or mortality in this systematic review.

Area of Science:

  • Nephrology
  • Rheumatology
  • Clinical Pharmacology

Background:

  • Hyperuricemia is a known risk factor for chronic kidney disease (CKD).
  • The efficacy of urate-lowering therapy (ULT) in preventing kidney function decline in asymptomatic hyperuricemia remains controversial.
  • This study addresses the impact of ULT on kidney function progression in patients without symptomatic gout.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials evaluating the effect of ULT on kidney function progression in asymptomatic hyperuricemia.
  • To assess whether ULT influences estimated glomerular filtration rate (eGFR) slopes, kidney events, and mortality.
  • To evaluate ULT's impact on serum uric acid levels and gout incidence.

Main Methods:

  • A systematic search of MEDLINE, EMBASE, and Cochrane databases was conducted for randomized controlled trials up to November 30, 2020.
  • Studies compared ULT with controlled therapies in patients with asymptomatic hyperuricemia.
  • Eleven studies were included for qualitative synthesis and meta-analysis.

Main Results:

  • ULT did not significantly improve eGFR slopes (WMD 0.36 ml/min/1.73 m² per year; 95% CI: -0.31, 1.04).
  • No significant reduction was observed in kidney events (RR 1.26; 95% CI: 0.80, 2.00) or all-cause mortality (RR 1.00; 95% CI: 0.65, 1.55).
  • ULT effectively lowered serum uric acid levels (WMD -2.73 mg/dl; 95% CI: -3.18, -2.28) and reduced gout incidence (RR 0.38; 95% CI: 0.17, 0.86).

Conclusions:

  • Urate-lowering therapy does not appear to slow kidney function progression in patients with asymptomatic hyperuricemia.
  • While effective for lowering uric acid and preventing gout, ULT's benefit on kidney function requires further investigation.
  • Larger, long-term studies are necessary to definitively ascertain the role of ULT in managing kidney health in this population.

Keywords:
asymptomatic hyperuricemiachronic kidney diseaseeGFR slopeskidney eventsurate-lowering therapy

More Related Videos

Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis04:37

Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis

Published on: April 25, 2025

839
Quantitative SERS Detection of Uric Acid via Formation of Precise Plasmonic Nanojunctions within Aggregates of Gold Nanoparticles and Cucurbit[n]uril10:02

Quantitative SERS Detection of Uric Acid via Formation of Precise Plasmonic Nanojunctions within Aggregates of Gold Nanoparticles and Cucurbit[n]uril

Published on: October 3, 2020

4.0K

Related Concept Videos

Urinary Tract Calculi IV: Nutrition Therapy and Prevention01:27

Urinary Tract Calculi IV: Nutrition Therapy and Prevention

Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
49
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
45
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
4
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
184
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
9
Antihypertensive Drugs: Action of Diuretics01:16

Antihypertensive Drugs: Action of Diuretics

Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
935