Related Experiment Video

Updated: May 26, 2025

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
07:13

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

4.2K

Monitoring and Management of Uric Acid Therapy in Gout and Chronic Kidney Disease: A Single-Center Retrospective

Ioannis Karageorgiou1, Zeeshan Javed2, Austen Grooms1

  • 1Internal Medicine, William Beaumont University Hospital, Royal Oak, USA.

Cureus
|February 24, 2025
PubMed

Insights

Adherence to gout treatment guidelines is low, with nearly half of patients not monitored and over half with high uric acid levels not receiving dose adjustments. Chronic kidney disease did not impact these outcomes.

Area of Science:

  • Nephrology
  • Rheumatology
  • Pharmacology

Background:

  • Gout frequently co-occurs with chronic kidney disease (CKD), impacting uric acid (UA) excretion.
  • Current guidelines advocate for regular monitoring and dose adjustments of urate-lowering therapy (ULT).
  • Adherence to these established ULT guidelines in clinical practice remains uncertain, particularly in patients with comorbidities.

Purpose of the Study:

  • To evaluate adherence to urate-lowering therapy (ULT) guidelines in gout patients.
  • To assess the influence of chronic kidney disease (CKD) and other comorbidities on ULT guideline adherence.

Main Methods:

  • Retrospective cohort study of 5,985 gout patients initiated on allopurinol (2015-2020).
  • Inclusion criteria: age >18, gout diagnosis, new allopurinol prescription.
  • Primary outcome: UA monitoring within six months; Secondary outcome: dose adjustments for elevated UA levels (>6 mg/dL).

Main Results:

  • Only 48.3% of patients had UA levels monitored within six months.
  • CKD stage did not significantly affect UA monitoring rates (p=0.059).
  • In patients with elevated UA levels, 54.3% did not have dosage adjustments.

Conclusions:

  • Significant gaps exist in adherence to ULT guidelines for gout management.
  • Nearly half of patients missed recommended UA monitoring, and over half with elevated UA levels did not receive timely dose adjustments.
  • CKD stage did not influence monitoring or dose adjustment rates in this patient cohort.

Keywords:
allopurinolchronic kidney disease (ckd)gout diseaseurate-lowering therapyuric acid levels

More Related Videos

Estimation of Urinary Nanocrystals in Humans using Calcium Fluorophore Labeling and Nanoparticle Tracking Analysis07:45

Estimation of Urinary Nanocrystals in Humans using Calcium Fluorophore Labeling and Nanoparticle Tracking Analysis

Published on: February 9, 2021

3.5K
Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography03:19

Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography

Published on: June 21, 2024

926

Related Concept Videos

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...
48
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
56
Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
104
Hormonal Regulation01:33

Hormonal Regulation

The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
32.8K
Glomerular Filtration Rate and its Regulation01:28

Glomerular Filtration Rate and its Regulation

The Glomerular Filtration Rate (GFR) is a measure of kidney function, reflecting the volume of filtrate formed per minute in the kidneys. On average, GFR is approximately 125 mL/min in males and 105 mL/min in females. Maintaining a relatively constant GFR is essential for the kidneys to effectively regulate body fluid homeostasis and maintain extracellular stability.
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
The myogenic...
2.2K
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...
611