Chronic kidney disease and hyperuricemia: an algorithm for prescribing urate-lowering therapy

According to recent large-scale epidemiological studies, every tenth individual worldwide is affected by chronic kidney disease (CKD). The majority of CKD cases are of cardiometabolic origin; moreover, patients with stages 3–5 represent a comorbid population with high or very high cardiovascular risk. Hyperuricemia (HU) is an established risk factor for both the development and progression of CKD as well as a number of commonly associated conditions, including arterial hypertension, coronary artery disease, chronic heart failure, type 2 diabetes mellitus, among others. The global prevalence of hyperuricemia is estimated to be approximately 12–25%. In patients with CKD, the frequency of hyperuricemia is higher than in the general population and increases as the glomerular filtration rate declines. Thus, it is essential that all CKD patients undergo regular monitoring of serum uric acid levels. Upon detection of hyperuricemia, lifestyle change and optimization of concomitant therapies should be implemented, and urate-lowering agents should be prescribed if these measures are insufficient. Keywords: chronic kidney disease, hyperuricemia, gout, urate nephropathy, allopurinol, febuxostat. For citation: Grigorieva E.V., Volgina G.V. Chronic kidney disease and hyperuricemia: an algorithm for prescribing urate-lowering therapy. RMJ. 2025;6:35–38. DOI: 10.32364/2225-2282-2025-6-7