# Management of gout in chronic kidney disease: a G-CAN Consensus Statement on the research priorities

**Authors:** Lisa K. Stamp, Hamish Farquhar, Huai Leng Pisaniello, Ana B. Vargas-Santos, Mark Fisher, David B. Mount, Hyon K. Choi, Robert Terkeltaub, Catherine L. Hill, Angelo L. Gaffo

PMC · DOI: 10.1038/s41584-021-00657-4 · Nature Reviews. Rheumatology · 2021-07-30

## TL;DR

This paper outlines the lack of clear evidence for managing gout in people with chronic kidney disease and identifies key research priorities.

## Contribution

The paper provides a consensus on research gaps and priorities for gout management in CKD patients.

## Key findings

- There is a lack of quality evidence to guide gout treatment in people with CKD.
- Conflicting recommendations exist for using urate-lowering therapy in advanced CKD.
- The paper identifies key areas for future research to improve gout and CKD management.

## Abstract

Gout and chronic kidney disease (CKD) frequently coexist, but quality evidence to guide gout management in people with CKD is lacking. Use of urate-lowering therapy (ULT) in the context of advanced CKD varies greatly, and professional bodies have issued conflicting recommendations regarding the treatment of gout in people with concomitant CKD. As a result, confusion exists among medical professionals about the appropriate management of people with gout and CKD. This Consensus Statement from the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) discusses the evidence and/or lack thereof for the management of gout in people with CKD and identifies key areas for research to address the challenges faced in the management of gout and CKD. These discussions, which address areas for research both in general as well as related to specific medications used to treat gout flares or as ULT, are supported by separately published G-CAN systematic literature reviews. This Consensus Statement is not intended as a guideline for the management of gout in CKD; rather, it analyses the available literature on the safety and efficacy of drugs used in gout management to identify important gaps in knowledge and associated areas for research.

In this Consensus Statement, members of the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) highlight gaps in knowledge about the management of gout in people with chronic kidney disease, and identify important areas for future research to address challenges in the treatment of this patient population.

## Linked entities

- **Diseases:** gout (MONDO:0005393), chronic kidney disease (MONDO:0005300)

## Full-text entities

- **Genes:** CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, REN (renin) [NCBI Gene 5972] {aka ADTKD4, HNFJ2, RTD}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}
- **Diseases:** myocardial infarction (MESH:D009203), joint erosion (MESH:D014077), GOUT (OMIM:138900), weight loss (MESH:D015431), acute coronary syndrome (MESH:D054058), cutaneous adverse drug reactions (MESH:D064420), CVD (MESH:D002318), ESRD (MESH:D007676), rheumatic diseases (MESH:D012216), renal function (MESH:D058186), hypertension (MESH:D006973), all-cause death (MESH:D003643), unstable angina (MESH:D000789), Hypersensitivity (MESH:D004342), gouty arthritis (MESH:D015210), AHS (MESH:D063926), function (MESH:D003291), stroke (MESH:D020521), -CAN (MESH:D007674), NSAIDS (MESH:D055963), Hyperuricemia (MESH:D033461), crystalluria (MESH:D000092162), Crystal-Associated Disease (MESH:D000070657), tophaceous disease (MESH:D004194), Ulceration (MESH:D014456), bone marrow suppression (MESH:D001855), infection (MESH:D007239), Gout (MESH:D006073), inflammatory arthritis (MESH:D001168), XOIs (MESH:C562584), inflammation (MESH:D007249), obesity (MESH:D009765), type 2 diabetes mellitus (MESH:D003924), arthritic diseases (MESH:D015535), reaction (MESH:D006967), renal insufficiency (MESH:D051437), CKD (MESH:D051436)
- **Chemicals:** probenecid (MESH:D011339), Allopurinol (MESH:D000493), omega-3 fatty acids (MESH:D015525), prednisone (MESH:D011241), Colchicine (MESH:D003078), pegloticase (MESH:C031545), canakinumab (MESH:C541220), prostaglandins (MESH:D011453), ULT (-), atorvastatin (MESH:D000069059), Lesinurad (MESH:C000593471), Oxypurinol (MESH:D010117), creatinine (MESH:D003404), leukotrienes (MESH:D015289), metformin (MESH:D008687), Benzbromarone (MESH:D001553), Febuxostat (MESH:D000069465), MSU (MESH:D014527),  (MESH:D006074)
- **Species:** Homo sapiens (human, species) [taxon 9606], Mus musculus (house mouse, species) [taxon 10090]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC8458096/full.md

## References

81 references — full list in the complete paper: https://tomesphere.com/paper/PMC8458096/full.md

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Source: https://tomesphere.com/paper/PMC8458096