@article{17215,
  author = {Hawley C. and Badve S. and Brown F. and Kanellis J. and Rangan G. and Johnson D. and Perkovic Vlado},
  title = {Challenges of conducting a trial of uric-acid-lowering therapy in CKD},
  abstract = {<p>
Observational studies have shown that asymptomatic hyperuricemia is associated with increased risks of hypertension, chronic kidney disease (CKD), end-stage renal disease, cardiovascular events, and mortality. Whether these factors represent cause, consequence or incidental associations, however, remains uncertain. Hyperuricemia could be a consequence of impaired kidney function, diuretic therapy or oxidative stress, such that elevated serum urate level represents a marker, rather than a cause, of CKD. On the other hand, small, short-term, single-center studies have shown improvements in blood-pressure control and slowing of CKD progression following serum urate lowering with allopurinol. An adequately powered randomized controlled trial is required to determine whether uric-acid-lowering therapy slows the progression of CKD. This article discusses the rationale for and the feasibility of such a trial. International collaboration is required to plan and conduct a large-scale multicenter trial in order to better inform clinical practice and public health policy about the optimal management of asymptomatic hyperuricemia in patients with CKD.
</p>
},
  year = {2011},
  journal = {Nature Reviews Nephrology},
  volume = {7},
  edition = {2011/02/16},
  number = {5},
  pages = {295-300},
  isbn = {1759-507X (Electronic)1759-5061 (Linking)},
  note = {Badve, Sunil VBrown, FionaHawley, Carmel MJohnson, David WKanellis, JohnRangan, Gopala KPerkovic, VladoEnglandNature reviews. NephrologyNat Rev Nephrol. 2011 May;7(5):295-300. Epub 2011 Feb 15.},
  language = {eng},
}