RESEARCH - Hyperuricaemia - where nephrology meets rheumatology

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Rheumatology Advance Access published online on April 27, 2008

Rheumatology, doi:10.1093/rheumatology/ken070

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Review

Hyperuricaemia—where nephrology meets rheumatology

Z. Avram and E. Krishnan

Division of Rheumatology, Department of Medicine, University of

Pittsburgh, Pittsburgh, PA, USA.

Abstract

Rheumatologists care for patients with gouty arthritis, a condition

caused by chronic and uncontrolled hyperuricaemia. Hyperuricaemia,

gout and renal dysfunction are often bedfellows, raising the

possibility of the former causing the latter. We sought the answer to

the question 'Among patients with normal measures of glomerular

filtration, does hyperuricaemia predict future renal disease'? We

identified prospective cohort studies evaluating the relationship

between serum uric acid and chronic kidney function from the past 20

yrs, through MEDLINE, Cochrane Library and EMBASE searches and

bibliography cross-referencing. Nine cohort studies that met the

selection criteria were found. Because of the extreme heterogeneity, a

statistical meta-analysis was not performed. Most (eight out of nine)

studies found an independent risk factor for deterioration of kidney

function. Nearly all published prospective studies support the role of

hyperuricaemia as an independent risk factor for renal dysfunction. In

the absence of large randomized controlled trials of uric acid

reduction, it remains uncertain if this relation is causal or merely

an epiphenomenon. Regardless, our review suggests that hyperuricaemia

is a useful, inexpensively measured, widely available and useful early

marker for chronic kidney disease.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken070v1?papetoc

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Not an MD