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The interplay between serum uric acid levels and kidney disease is complex: Renal dysfunction predisposes to hyperuricemia, but whether hyperuricemia also exacerbates renal dysfunction is controversial. If the latter is true, then urate-lowering therapy might be expected to impede progression of chronic kidney disease (CKD; NEJM JW Gen Med Aug 15 2017 and Ann Rheum Dis 2017; 76:1669; NEJM JW Gen Med Nov 15 2018 and JAMA Intern Med 2018; 178:1526).
In this study, Japanese researchers randomized 443 patients with asymptomatic elevations in serum uric acid (7–10 mg/dL) and stage 3 CKD (estimated glomerular filtration rate [GFR], 30–60 mL/minute/1.73 m2) to receive either placebo or the urate-lowering drug febuxostat (Uloric). During 2 years of …