Association between serum uric acid and kidney disease with pediatric focus

Hyperuricemia is a global medical issue. Kidney disease and hyperuricemia are clearly related. Whether uric acid is a disease bystander or a therapeutic target in chronic kidney disease (CKD) remains controversial. Uric acid is involved in various mechanisms that worsen kidney function, and many epidemiological and animal studies have shown an association between hyperuricemia and kidney deterioration. However, several confounding variables limit this interpretation of the relationship. Two recent large well-designed studies failed to show that allopurinol, a uric acid-lowering agent, slows the decline in glomerular filtration rate. Nevertheless, this conclusion remains premature. The role of uric acid-lowering agents in delaying disease progression in patients with early-stage CKD, such as pediatric patients, requires further study.