Uric acid lowering for slowing CKD progression after the CKD-FIX trial: a solved question or still a dilemma?

ABSTRACT Hyperuricemia has been associated with several cardiovascular risk factors and is a well-known predictor of kidney disease. In vitro studies as well as animal models highlighted a role for uric acid in the development and progression of haemodynamic and tissue damage at the renal level lead...

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Published in:Clinical kidney journal 2022-09, Vol.15 (9), p.1666-1674
Main Authors: Leoncini, Giovanna, Barnini, Cecilia, Manco, Luca, Nobili, Giulia, Dotta, Daniele, Penso, Martina, Russo, Elisa, Cappadona, Francesca, Viazzi, Francesca, Pontremoli, Roberto
Format: Article
Language:English
Subjects:
Analysis
Cardiovascular diseases
Chronic kidney failure
CKJ Review
Medical research
Medicine, Experimental
Oxidases
Rasburicase
Type 2 diabetes
Uric acid
Valsartan
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Summary:ABSTRACT Hyperuricemia has been associated with several cardiovascular risk factors and is a well-known predictor of kidney disease. In vitro studies as well as animal models highlighted a role for uric acid in the development and progression of haemodynamic and tissue damage at the renal level leading to glomerular and tubulointerstitial abnormalities. Urate-lowering treatment, especially by xanthine oxidase inhibitors, has been proposed in order to improve kidney outcomes. However, recent randomized controlled trials failed to demonstrate a beneficial effect of allopurinol or febuxostat on renal disease, casting doubts on the role of this therapeutical approach to improve nephroprotection. We provide a critical overview of current literature on this topic and offer a possible interpretation of results from recent intervention trials with urate-lowering treatment on renal outcomes.
ISSN:2048-8505
2048-8513
DOI:10.1093/ckj/sfac075