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Management of Gout and Hyperuricemia in CKD.

Abstract
Hyperuricemia and gout, the clinical manifestation of monosodium urate crystal deposition, are common in patients with chronic kidney disease (CKD). Although the presence of CKD poses additional challenges in gout management, effective urate lowering is possible for most patients with CKD. Initial doses of urate-lowering therapy are lower than in the non-CKD population, whereas incremental dose escalation is guided by regular monitoring of serum urate levels to reach the target level of <6mg/dL (or <5mg/dL for patients with tophi). Management of gout flares with presently available agents can be more challenging due to potential nephrotoxicity and/or contraindications in the setting of other common comorbid conditions. At present, asymptomatic hyperuricemia is not an indication for urate-lowering therapy, though emerging data may support a potential renoprotective effect.
AuthorsAna Beatriz Vargas-Santos, Tuhina Neogi
JournalAmerican journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 70 Issue 3 Pg. 422-439 (Sep 2017) ISSN: 1523-6838 [Electronic] United States
PMID28456346 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Gout Suppressants
  • Febuxostat
  • Uric Acid
  • Allopurinol
Topics
  • Allopurinol (administration & dosage)
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
  • Diet Therapy (methods)
  • Disease Management
  • Febuxostat (administration & dosage)
  • Gout (diagnosis, etiology, metabolism, therapy)
  • Gout Suppressants (administration & dosage)
  • Humans
  • Hyperuricemia (diagnosis, drug therapy, etiology, metabolism)
  • Male
  • Middle Aged
  • Renal Dialysis (adverse effects, methods)
  • Renal Insufficiency, Chronic (complications, diagnosis, metabolism, therapy)
  • Symptom Flare Up
  • Treatment Outcome
  • Uric Acid (blood)

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