Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy
The relationship between hyperuricemia, gout, and renal disease has been investigated for several years. From the beginning, kidney disease has been considered a complication of gout; however, the viewpoints changed, claiming that hypertension and elevated uric acid (UA) levels are caused by decreas...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/9/1674 |
| _version_ | 1829452837450416128 |
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| author | Tao Han Lee Jia-Jin Chen Chao-Yi Wu Chih-Wei Yang Huang-Yu Yang |
| author_facet | Tao Han Lee Jia-Jin Chen Chao-Yi Wu Chih-Wei Yang Huang-Yu Yang |
| author_sort | Tao Han Lee |
| collection | DOAJ |
| description | The relationship between hyperuricemia, gout, and renal disease has been investigated for several years. From the beginning, kidney disease has been considered a complication of gout; however, the viewpoints changed, claiming that hypertension and elevated uric acid (UA) levels are caused by decreased urate excretion in patients with renal impairment. To date, several examples of evidence support the role of hyperuricemia in cardiovascular or renal diseases. Several mechanisms have been identified that explain the relationship between hyperuricemia and chronic kidney disease, including the crystal effect, renin–angiotensin–aldosterone system activation, nitric oxide synthesis inhibition, and intracellular oxidative stress stimulation, and urate-lowering therapy (ULT) has been proven to reduce renal disease progression in the past few years. In this comprehensive review, the source and physiology of UA are introduced, and the mechanisms that explain the reciprocal relationship between hyperuricemia and kidney disease are reviewed. Lastly, current evidence supporting the use of ULT to postpone renal disease progression in patients with hyperuricemia and gout are summarized. |
| first_indexed | 2024-03-10T07:45:43Z |
| format | Article |
| id | doaj.art-a51240cb4f204255af3a9dd2b7dd31ac |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T07:45:43Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a51240cb4f204255af3a9dd2b7dd31ac2023-11-22T12:40:40ZengMDPI AGDiagnostics2075-44182021-09-01119167410.3390/diagnostics11091674Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering TherapyTao Han Lee0Jia-Jin Chen1Chao-Yi Wu2Chih-Wei Yang3Huang-Yu Yang4Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, TaiwanDepartment of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, TaiwanDepartment of Pediatrics, Division of Allergy, Asthma, and Rheumatology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, TaiwanDepartment of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, TaiwanDepartment of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, TaiwanThe relationship between hyperuricemia, gout, and renal disease has been investigated for several years. From the beginning, kidney disease has been considered a complication of gout; however, the viewpoints changed, claiming that hypertension and elevated uric acid (UA) levels are caused by decreased urate excretion in patients with renal impairment. To date, several examples of evidence support the role of hyperuricemia in cardiovascular or renal diseases. Several mechanisms have been identified that explain the relationship between hyperuricemia and chronic kidney disease, including the crystal effect, renin–angiotensin–aldosterone system activation, nitric oxide synthesis inhibition, and intracellular oxidative stress stimulation, and urate-lowering therapy (ULT) has been proven to reduce renal disease progression in the past few years. In this comprehensive review, the source and physiology of UA are introduced, and the mechanisms that explain the reciprocal relationship between hyperuricemia and kidney disease are reviewed. Lastly, current evidence supporting the use of ULT to postpone renal disease progression in patients with hyperuricemia and gout are summarized.https://www.mdpi.com/2075-4418/11/9/1674hyperuricemiagoutchronic kidney diseasexanthine oxidase inhibitorallopurinolfebuxostat |
| spellingShingle | Tao Han Lee Jia-Jin Chen Chao-Yi Wu Chih-Wei Yang Huang-Yu Yang Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy Diagnostics hyperuricemia gout chronic kidney disease xanthine oxidase inhibitor allopurinol febuxostat |
| title | Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy |
| title_full | Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy |
| title_fullStr | Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy |
| title_full_unstemmed | Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy |
| title_short | Hyperuricemia and Progression of Chronic Kidney Disease: A Review from Physiology and Pathogenesis to the Role of Urate-Lowering Therapy |
| title_sort | hyperuricemia and progression of chronic kidney disease a review from physiology and pathogenesis to the role of urate lowering therapy |
| topic | hyperuricemia gout chronic kidney disease xanthine oxidase inhibitor allopurinol febuxostat |
| url | https://www.mdpi.com/2075-4418/11/9/1674 |
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