Controversies and practical management of patients with gout and chronic kidney disease.

Autor:	Johnson RJ; Division of Renal Diseases, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Mandell BF; Department of Rheumatologic and Immunologic Disease, Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, Ohio, USA., Schlesinger N; Division of Rheumatology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA., Mount DB; Renal Divisions, Brigham and Women's Hospital and VA Boston Healthcare System, Harvard Medical School, Boston; Massachusetts, USA., Botson JK; Orthopedic Physicians Alaska, Anchorage, Alaska, USA., Abdellatif AA; Baylor College of Medicine and CLS Health, Houston, Texas, USA., Rhoades R; RWR Inc., Steamboat Springs, Colorado, USA., Singh JA; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA. Electronic address: Jasvinder.md@gmail.com.
Jazyk:	angličtina
Zdroj:	Kidney international [Kidney Int] 2024 Oct; Vol. 106 (4), pp. 573-582. Date of Electronic Publication: 2024 Jul 20.
DOI:	10.1016/j.kint.2024.05.033
Abstrakt:	Uric acid is a toxin retained with advancing kidney disease. Clinical manifestations of hyperuricemia include gout and systemic inflammation that are associated with increased risk of cardiovascular mortality. As many as one-third of all patients with chronic kidney disease have a history of gout, yet <25% of these patients are effectively treated to target serum urate levels of ≤6 mg/dl. A major reason for ineffective management of gout and hyperuricemia is the complexity in managing these patients, with some medications contraindicated and others requiring special dosing, potential drug interactions, and other factors. Consequently, many nephrologists do not primarily manage gout despite it being a common complication of chronic kidney disease, leaving management to the primary physician or rheumatologist. We believe that kidney specialists should consider gout as a major complication of chronic kidney disease and actively manage it in their patients. Here, we present insights from nephrologists and rheumatologists for a team approach to gout management that includes the nephrologist. (Copyright © 2024 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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