慢性肾脏病相关痛风管理:G-CAN 共识声明中关于研究重点的内容

Management of gout in chronic kidney disease: a G-CAN Consensus Statement on the research priorities.

机构信息

University of Otago, Christchurch, New Zealand.

Discipline of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

出版信息

Nat Rev Rheumatol. 2021 Oct;17(10):633-641. doi: 10.1038/s41584-021-00657-4. Epub 2021 Jul 30.

Abstract

Gout and chronic kidney disease (CKD) frequently coexist, but quality evidence to guide gout management in people with CKD is lacking. Use of urate-lowering therapy (ULT) in the context of advanced CKD varies greatly, and professional bodies have issued conflicting recommendations regarding the treatment of gout in people with concomitant CKD. As a result, confusion exists among medical professionals about the appropriate management of people with gout and CKD. This Consensus Statement from the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) discusses the evidence and/or lack thereof for the management of gout in people with CKD and identifies key areas for research to address the challenges faced in the management of gout and CKD. These discussions, which address areas for research both in general as well as related to specific medications used to treat gout flares or as ULT, are supported by separately published G-CAN systematic literature reviews. This Consensus Statement is not intended as a guideline for the management of gout in CKD; rather, it analyses the available literature on the safety and efficacy of drugs used in gout management to identify important gaps in knowledge and associated areas for research.

摘要

痛风和慢性肾脏病(CKD)常同时存在,但缺乏高质量证据来指导 CKD 患者的痛风管理。在 CKD 晚期使用降尿酸治疗(ULT)的情况差异很大,专业机构对同时患有 CKD 的痛风患者的治疗提出了相互矛盾的建议。因此,医务人员在痛风和 CKD 患者的适当管理方面存在困惑。痛风、高尿酸血症和晶体相关疾病网络(G-CAN)的这份共识声明讨论了 CKD 患者痛风管理的证据和/或缺乏证据,并确定了研究的关键领域,以解决痛风和 CKD 管理中面临的挑战。这些讨论涉及一般领域和专门用于治疗痛风发作或作为 ULT 的特定药物的研究领域,得到了 G-CAN 系统文献综述的支持。本共识声明并非旨在作为 CKD 患者痛风管理的指南;相反,它分析了痛风管理中使用药物的安全性和有效性的现有文献,以确定知识的重要差距和相关研究领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b237/8458096/98ec9350b3cf/41584_2021_657_Fig1_HTML.jpg

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