Uric Acid as a Risk Factor for Chronic Kidney Disease and cardiovascular disease ― Japanese Guideline on the Management of Asymptomatic Hyperuricemia ―
Hyperuricemia is one of the common reasons for the occurrence of vascular diseases such as chronic kidney disease (CKD) and cardiovascular disease (CVD). While different guidelines state contrasting recommendations, it is still a topic of debate whether pharmacological treatment of hyperuricemia should be administered in patients with CKD/CVD. Ichiro Hisatome and colleagues published a review paper in the Circulation Journal under the title “Uric Acid as a Risk Factor for Chronic Kidney Disease and cardiovascular disease ― Japanese Guideline on the Management of Asymptomatic Hyperuricemia ―”. The summary of this paper can be studied below:
Objective:
To evaluate whether pharmacological treatment of hyperuricemia should be administered in patients with CKD.
Method:
The review paper based on the recommendations from various available guidelines along with practical and clinical knowledge of health professionals.
Findings:
There are chances of developing vascular diseases as hyperuricemia impairs endothelial function. Although The Japanese Guideline on the Management of Hyperuricemia and Gout (JGMHG) 3rd edition and American College of Rheumatology Guideline for the Management of Gout (ACR 2020) are developed based on the GRADE method, there is a difference between the recommendations on urate-lowering agents (ULAs) provided in both guidelines. This difference can be explained by the different situations of the Medicare system in both countries and patient’s opinions. As per The JGMHG 3rd edition, pharmacological treatment of hyperuricemia can be initiated in patients with CKD. Additionally, ULAs could be used with patient’s consent in order to reduce mortality in hyperuricemic patients with either hypertension or heart failure.
Authors acknowledge future studies to evaluate the rationality of using ULAs to improve the prognosis of hyperuricemic patients with CVD.
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