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Review
. 2015 Dec;32(12):1177-91.
doi: 10.1007/s12325-015-0272-7. Epub 2015 Dec 9.

Management of Chronic Kidney Disease: The Relationship Between Serum Uric Acid and Development of Nephropathy

Christian Mende  1
Affiliations
Review

Management of Chronic Kidney Disease: The Relationship Between Serum Uric Acid and Development of Nephropathy

Christian Mende. Adv Ther. 2015 Dec.

Abstract

Chronic kidney disease (CKD) is increasingly recognized as a global health problem, and new and effective strategies are needed for the management of this condition. Recently, there has been renewed interest in the relationship between serum uric acid (SUA) levels and CKD, and several recent trials have demonstrated a possible link between SUA and the development and/or progression of CKD in patients with and without diabetes. The identification of key urate transporters such as urate transporter 1 and glucose transporter 9 has provided not only insights into the pathophysiology of hyperuricemia, but also possible links to other processes, such as glucose homeostasis. The renewed interest in the role of SUA in CKD has coincided with the development of sodium glucose co-transporter 2 inhibitors for the treatment of diabetes. In addition to improving glycemic control, these agents, acting via the kidneys in an insulin-independent manner, have also been shown to reduce SUA levels and potentially improve some measures of renal function. This review will discuss the role of uric acid in CKD treatment, and how SUA-lowering therapies may prevent or delay the progression of CKD.

Funding: Janssen Scientific Affairs.

Keywords: Chronic kidney disease; Diabetes; Diabetic nephropathy; Nephrology; Renoprotection; Serum uric acid; Sodium glucose co-transporter 2 (SGLT 2) inhibitors.

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Figures

Fig. 1
Fig. 1
Potential mechanisms of uric acid-induced kidney disease [4]. COX-2 Cyclooxygenase-2, ECM extracellular matrix, EMT epithelial-to-mesenchymal transition, NO nitric oxide, RAS renin–angiotensin system, VEC vascular endothelial cells, VSMC vascular smooth muscle cells. Reprinted from Seminars in Nephrology, Vol. 32, Issue 5. Kang DH, Chen W, Uric acid and chronic kidney disease: new understanding of an old problem. pp. 447–52. Copyright 2011, with permission from Elsevier
See this image and copyright information in PMC

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