Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study
Chronic kidney disease (CKD) is a prevalent global health concern affecting approximately 850 million people worldwide, with a significant and rising mortality rate. CKD often coexists with hyperuricemia (HSUA), which is also increasingly common due to its association with hypertension, obesity, and...
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2025-01-01
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| author | Cecilia Barnini Elisa Russo Giovanna Leoncini Maria Carla Ghinatti Lucia Macciò Michela Piaggio Francesca Viazzi Roberto Pontremoli |
| author_facet | Cecilia Barnini Elisa Russo Giovanna Leoncini Maria Carla Ghinatti Lucia Macciò Michela Piaggio Francesca Viazzi Roberto Pontremoli |
| author_sort | Cecilia Barnini |
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| description | Chronic kidney disease (CKD) is a prevalent global health concern affecting approximately 850 million people worldwide, with a significant and rising mortality rate. CKD often coexists with hyperuricemia (HSUA), which is also increasingly common due to its association with hypertension, obesity, and diabetes. The interplay between hyperuricemia and CKD is complex; while in vitro studies and animal models support a role for uric acid mediating glomerular and tubule-interstitial damage, and HSUA has been shown to predict the onset and progression of CKD, the expectations of renal protection by the use of urate lowering treatment (ULT) are inconsistent. A significant challenge in managing asymptomatic HSUA in CKD patients lies in determining the appropriate SUA threshold values. Recent research, including the URRAH project, has sought to identify SUA cut-offs predictive of cardiovascular mortality, but these thresholds may vary depending on the severity of CKD. This variability complicates the establishment of universal guidelines for treating asymptomatic HSUA, leading to a lack of specific recommendations in clinical practice. In conclusion, while hyperuricemia is recognized as a prognostic factor for CKD and cardiovascular risk, more research is needed to refine the threshold values for SUA and to identify which patients may benefit from ULT. Stratification based on glomerular filtration rate may be necessary to tailor the treatments and improve outcomes in this population. |
| format | Article |
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| institution | Kabale University |
| issn | 2218-1989 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Metabolites |
| spelling | doaj-art-e4a79198cd544f2d99a7ec7b8537fda82025-01-24T13:41:09ZengMDPI AGMetabolites2218-19892025-01-011511110.3390/metabo15010011Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH StudyCecilia Barnini0Elisa Russo1Giovanna Leoncini2Maria Carla Ghinatti3Lucia Macciò4Michela Piaggio5Francesca Viazzi6Roberto Pontremoli7Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, 6020 Innsbruck, Tirol, AustriaDepartment of Internal Medicine and Medical Specialties (DiMI), University of Genoa, 16132 Genoa, ItalyDepartment of Internal Medicine and Medical Specialties (DiMI), University of Genoa, 16132 Genoa, ItalyInternal Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, ItalyDepartment of Internal Medicine and Medical Specialties (DiMI), University of Genoa, 16132 Genoa, ItalyUnit of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, ItalyDepartment of Internal Medicine and Medical Specialties (DiMI), University of Genoa, 16132 Genoa, ItalyDepartment of Internal Medicine and Medical Specialties (DiMI), University of Genoa, 16132 Genoa, ItalyChronic kidney disease (CKD) is a prevalent global health concern affecting approximately 850 million people worldwide, with a significant and rising mortality rate. CKD often coexists with hyperuricemia (HSUA), which is also increasingly common due to its association with hypertension, obesity, and diabetes. The interplay between hyperuricemia and CKD is complex; while in vitro studies and animal models support a role for uric acid mediating glomerular and tubule-interstitial damage, and HSUA has been shown to predict the onset and progression of CKD, the expectations of renal protection by the use of urate lowering treatment (ULT) are inconsistent. A significant challenge in managing asymptomatic HSUA in CKD patients lies in determining the appropriate SUA threshold values. Recent research, including the URRAH project, has sought to identify SUA cut-offs predictive of cardiovascular mortality, but these thresholds may vary depending on the severity of CKD. This variability complicates the establishment of universal guidelines for treating asymptomatic HSUA, leading to a lack of specific recommendations in clinical practice. In conclusion, while hyperuricemia is recognized as a prognostic factor for CKD and cardiovascular risk, more research is needed to refine the threshold values for SUA and to identify which patients may benefit from ULT. Stratification based on glomerular filtration rate may be necessary to tailor the treatments and improve outcomes in this population.https://www.mdpi.com/2218-1989/15/1/11uric acidkidney diseasecut-offscardiovascular risk |
| spellingShingle | Cecilia Barnini Elisa Russo Giovanna Leoncini Maria Carla Ghinatti Lucia Macciò Michela Piaggio Francesca Viazzi Roberto Pontremoli Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study Metabolites uric acid kidney disease cut-offs cardiovascular risk |
| title | Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study |
| title_full | Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study |
| title_fullStr | Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study |
| title_full_unstemmed | Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study |
| title_short | Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study |
| title_sort | asymptomatic hyperuricemia and the kidney lessons from the urrah study |
| topic | uric acid kidney disease cut-offs cardiovascular risk |
| url | https://www.mdpi.com/2218-1989/15/1/11 |
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