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[Hyperuricemia and kidney damage in patients with cardiovascular disease: A review]
1Sechenov First Moscow State Medical University (Sechenov University).
Insights
High uric acid (UA) levels are linked to kidney and heart problems. Urate-lowering therapy may slow kidney decline in chronic kidney disease (CKD) patients, even without gout.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Uric acid (UA) significantly impacts kidney function and cardiovascular health, increasing associated risks.
- Hyperuricemia, with or without crystal deposition, is strongly correlated with diminished kidney function and elevated cardiovascular risk.
- Chronic kidney disease (CKD) patients frequently have co-existing cardiovascular diseases or multiple risk factors.
Conclusions:
- Urate-lowering therapy is a promising strategy for managing CKD, particularly in patients with cardiovascular comorbidities.
- Current CKD guidelines may not fully reflect the benefits of urate-lowering interventions.
- Xanthine oxidase inhibitors, especially allopurinol for advanced CKD, warrant consideration for improved patient outcomes.
Abstract:
Many studies have been conducted confirming the effect of uric acid (UA) on kidney function. It is obvious that there is a relationship between the effect of UA not only on kidney function, but also on the cardiovascular system, increasing cardiovascular risk. The review article provides basic information about the pathogenesis, principles and features of prescribing therapy to patients with chronic kidney disease (CKD) and cardiovascular disease. A lot of data currently indicates that hyperuricemia, both with and without crystal deposition, is associated with high cardiovascular risk and decreased kidney function. A number of studies and meta-analyses indicate that urate-reducing therapy prevents and slows down the decline in kidney function in patients with CKD, many of whom suffer from cardiovascular diseases or at least have several risk factors. Despite the fact that currently the guidelines for the treatment of CKD do not include a recommendation for the start of urate-lowering therapy, a large amount of data has been accumulated on the potential benefits of such treatment even in the absence of a diagnosis of gout. The preferred group of drugs for this group of patients are xanthine oxidase inhibitors, and for patients with eGFR below 30 ml/min/1.73 m2, it seems that allopurinol currently has larger evidence base for the efficacy and safety of prescribing.
