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

• Published in: Nature reviews. Rheumatology 2021-10, Vol.17 (10), p.633-641
• Main Authors: Stamp, Lisa K., Farquhar, Hamish, Pisaniello, Huai Leng, Vargas-Santos, Ana B., Fisher, Mark, Mount, David B., Choi, Hyon K., Terkeltaub, Robert, Hill, Catherine L., Gaffo, Angelo L.
• Format: Article
• Language: English
• Subjects: 692/308; 692/4023/1670/3/2765/1528; Biomedical Research; Care and treatment; Chronic kidney failure; Consensus Statement; Disease management; Gout; Gout - complications; Gout - diagnosis; Gout - drug therapy; Gout Suppressants - adverse effects; Gout Suppressants - therapeutic use; Humans; Hyperuricemia; Hyperuricemia - drug therapy; Hyperuricemia - etiology; Kidney diseases; Literature reviews; Medical personnel; Medicine; Medicine & Public Health; Practice guidelines (Medicine); Renal Insufficiency, Chronic - classification; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - drug therapy; Rheumatology; Uric acid
• ISSN: 1759-4790; 1759-4804
• DOI: 10.1038/s41584-021-00657-4

Gout and chronic kidney disease (CKD) frequently coexist, but quality evidence to guide gout management in people with CKD is lacking. Use of urate-lowering therapy (ULT) in the context of advanced CKD varies greatly, and professional bodies have issued conflicting recommendations regarding the treatment of gout in people with concomitant CKD. As a result, confusion exists among medical professionals about the appropriate management of people with gout and CKD. This Consensus Statement from the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) discusses the evidence and/or lack thereof for the management of gout in people with CKD and identifies key areas for research to address the challenges faced in the management of gout and CKD. These discussions, which address areas for research both in general as well as related to specific medications used to treat gout flares or as ULT, are supported by separately published G-CAN systematic literature reviews. This Consensus Statement is not intended as a guideline for the management of gout in CKD; rather, it analyses the available literature on the safety and efficacy of drugs used in gout management to identify important gaps in knowledge and associated areas for research. In this Consensus Statement, members of the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) highlight gaps in knowledge about the management of gout in people with chronic kidney disease, and identify important areas for future research to address challenges in the treatment of this patient population.