Evidence map›Paper›PMID 31296965›Full record

ReviewNature reviews. Nephrology2019

The case for uric acid-lowering treatment in patients with hyperuricaemia and CKD.

Yuka Sato, Daniel I Feig, Austin G Stack, Duk-Hee Kang, Miguel A Lanaspa, A Ahsan Ejaz, L Gabriela Sánchez-Lozada, Masanari Kuwabara, Claudio Borghi, Richard J Johnson

Abstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

94 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  5. SGLT2 Inhibition and Uric Acid Excretion in Patients with Type 2 Diabetes and Normal Kidney Function.Clinical journal of the American Society of Nephrology : CJASN · 2022
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  7. Effect of Intensive Urate Lowering With Combined Verinurad and Febuxostat on Albuminuria in Patients With Type 2 Diabetes: A Randomized Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021
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  11. Review
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34 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Yuka SatoDivision of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Daniel I FeigDivision of Pediatric Nephrology, University of Alabama, Birmingham, AL, USA.
Austin G StackDivision of Nephrology, Department of Medicine, University Hospital Limerick, Limerick, Ireland.
Duk-Hee KangDivision of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine Ewha Medical Research Center, Seoul, South Korea.
Miguel A LanaspaDivision of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
A Ahsan EjazDivision of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL, USA.
L Gabriela Sánchez-LozadaLaboratory of Renal Physiopathology, Department of Nephrology, INC Ignacio Chavez, Mexico City, Mexico.
Masanari KuwabaraDepartment of Cardiology and Intensive Care Unit, Toranomon Hospital, Tokyo, Japan.
Claudio BorghiDepartment of Medicine, University of Bologna, Bologna, Italy.
Richard J JohnsonDivision of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. richard.johnson@ucdenver.edu.ORCID http://orcid.org/0000-0003-3312-8193

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hyperuricaemia is common among patients with chronic kidney disease (CKD), and increases in severity with the deterioration of kidney function. Although existing guidelines for CKD management do not recommend testing for or treatment of hyperuricaemia in the absence of a diagnosis of gout or urate nephrolithiasis, an emerging body of evidence supports a direct causal relationship between serum urate levels and the development of CKD. Here, we review randomized clinical trials that have evaluated the effect of urate-lowering therapy (ULT) on the rate of CKD progression. Among trials in which individuals in the control arm experienced progressive deterioration of kidney function (which we define as ≥4 ml/min/1.73 m² over the course of the study - typically 6 months to 2 years), treatment with ULT conferred consistent clinical benefits. In contrast, among trials where clinical progression was not observed in the control arm, treatment with ULT was ineffective, but this finding should not be used as an argument against the use of uric acid-lowering therapy. Although additional studies are needed to identify threshold values of serum urate for treatment initiation and to confirm optimal target levels, we believe that sufficient evidence exists to recommend routine measurement of serum urate levels in patients with CKD and consider initiation of ULT among those who are hyperuricaemic with evidence of deteriorating renal function, unless specific contraindications exist.

Indexed as

HumansHyperuricemiaRenal Insufficiency, ChronicUric AcidUric Acid

Identifiers

PMID31296965

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.