Treatment of Chronic Kidney Disease with Symptomatic Hyperuricemia
Clinical Scenario
This protocol covers patients who have chronic kidney disease alongside symptomatic hyperuricemia — elevated uric acid that is producing clinical symptoms, including acute gout flares.
Condition Context
In people with CKD and symptomatic hyperuricemia, guidelines recommend offering uric acid–lowering intervention. The presence of reduced kidney function directly shapes which agents are appropriate and which carry unacceptable risk.
Treatment Approach — Partial Overview
The recommended strategy centres on uric acid–lowering therapy, with a xanthine oxidase inhibitor approach preferred over uricosuric agents in this population. For acute symptomatic episodes, specific anti-inflammatory options are preferred over NSAIDs given their kidney risk profile.
Agent selection, sequencing, and full guidance are available in the complete protocol →
References
DOI: 10.1016/j.kint.2023.10.018
- We recommend people with CKD and symptomatic hyperuricemia should be offered uric acid–lowering intervention (1C).
- Prescribe xanthine oxidase inhibitors in preference to uricosuric agents in people with CKD and symptomatic hyperuricemia.
- For symptomatic treatment of acute gout in CKD, low-dose colchicine or intra-articular/oral glucocorticoids are preferable to nonsteroidal anti-inflammatory drugs (NSAIDs).
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