Urate-lowering therapy and kidney function

Chronic hyperuricemia (CH) and gout are independent risk factors for decreased kidney function. In the last decade, evidence was accumulating that urate-lowering therapy may be an effective method of slowing down the progression of CH and gout-mediated renal failure. At the same time, the main goal of gout therapy is the complete resorption of urate crystals, which leads to resolution of the disease, but is impossible without longterm use of urate-lowering drugs. However, the treatment of gout in the presence of chronic kidney disease is much more complex and requires consideration of the potential impact of drugs on targeted serum uric acid level and on renal function, as well as predicting the risk of adverse events. The article presents practical recommendations regarding the use of urate-lowering drugs in gout patients with chronic kidney disease.