Recommendation ID
CG182/4
Question
In people with CKD who are at high risk of progression, what is the clinical and cost effectiveness
of uric acid-lowering agents on the progression of CKD and on mortality?
Any explanatory notes
(if applicable)
Why this is important: Observational data have suggested that uric acid is an independent predictor of both progression and new incidence of CKD. It has also been proposed that elevated uric acid may have a role in initiating hypertension, arteriolosclerosis, insulin resistance and hypertriglyceridaemia. Hyperuricaemia is also associated with type 2 diabetes. It is difficult to infer causation from the observational data; is hyperuricaemia nephrotoxic or a marker of reduced eGFR? Is the relationship due to residual confounding? The current randomised evidence for reducing uric acid in CKD patients is very limited and of poor quality, especially relating to the major outcomes of end-stage kidney disease needing renal replacement therapy and mortality.

Source guidance details

Comes from guidance
Chronic kidney disease in adults: assessment and management
Number
CG182
Date issued
July 2014

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 07/10/2014