摘要 : Gout, a debilitating inflammatory arthritis, currently affects more than 9 million Americans. Hyperuricemia, the labo-ratory abnormality associated with the development of gout, also occurs in a significant number of patients with... 展开 Gout, a debilitating inflammatory arthritis, currently affects more than 9 million Americans. Hyperuricemia, the labo-ratory abnormality associated with the development of gout, also occurs in a significant number of patients with chronic kidney disease (CKD), a condition that affects approximately 14% of the US population. Several recent studies have attempted to provide a definitive link between the presence of hyperuricemia and progression of CKD; however, the treatment of asymptomatic hyperuricemia in CKD is not supported by recent randomized controlled tri-als. The pharmacology of acute gout flares and urate lowering is complicated in patients who also have evidence of CKD, primarily because of an increased risk of medication toxicity. Recipients of kidney transplants are particularly at risk of debilitating gout and medication toxicity. We review the available data linking CKD, gout, and hyperurice-mia, providing practice guidelines on managing gout in CKD patients and kidney transplant recipients. We advocate for much greater involvement of nephrologists in the management of gout in renal patients. Semin Nephrol 40:600?613 Published by Elsevier Inc. 收起