Role of asymptomatic hyperuricemia in the progression of chronic kidney disease and cardiovascular disease

Korean J Intern Med. 2021 Nov;36(6):1281-1293. doi: 10.3904/kjim.2020.340. Epub 2021 Jul 8.

Abstract

Previous research has investigated whether hyperuricemia serves as an independent risk factor for cardiovascular and renal diseases. Hyperuricemia is defined as an abnormally high level of uric acid (UA; i.e., serum urate level > 6.8 mg/dL). Hyperuricemia has been considered a complication of chronic kidney disease (CKD). However, it seems to play a pathogenic role in the progression of renal diseases. There has been increasing focus on the link between hyperuricemia and CKD. The results of randomized controlled trials have implied independent associations between hyperuricemia and the progression of cardiovascular and renal morbidities. These associations may be mediated by renin-angiotensin system activation, nitric oxide synthase inhibition, and macrovascular/microvascular disease development. There remains controversy regarding the use of serum UA level as an indirect index of renal vascular disease. This literature review focuses on the role of asymptomatic hyperuricemia in the progression of CKD, as well as the association between hyperuricemia and cardiovascular disease. It also provides a general overview of the physiological metabolism of UA.

Keywords: Cardiovascular diseases; Chronic kidney disease; Febuxostat; Hyperuricemia; Xanthine oxidase.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Gout Suppressants / therapeutic use
  • Humans
  • Hyperuricemia* / diagnosis
  • Hyperuricemia* / epidemiology
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / drug therapy
  • Renal Insufficiency, Chronic* / epidemiology
  • Uric Acid

Substances

  • Gout Suppressants
  • Uric Acid