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Management of asymptomatic hyperuricemia in patients with chronic kidney disease by Japanese nephrologists: A questionnaire survey.
MedLine Citation:
PMID:  21303423     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:  Hyperuricemia is associated with chronic kidney disease (CKD) progression and cardiovascular events (CVE). In a US study, only 4% of rheumatologists initiated urate-lowering therapy in patients with asymptomatic hyperuricemia (AHU). The present study aimed to clarify how Japanese board-certified nephrologists manage AHU in CKD patients. Methods:  Questionnaires on management of AHU in CKD stage 3 or more were mailed to 1500 Japanese board-certified nephrologists, excluding pediatricians and urologists, randomly selected from the directory of the Japanese Society of Nephrology (n = 2976). Results:  Five hundred ninety-five nephrologists (40%) responded. Most nephrologists (84-89%) recommended that AHU in patients on CKD stages 3-5 should be treated, but fewer nephrologists (63%) recommended AHU in patients on CKD stage 5D should be treated. The serum urate level to start urate-lowering therapy and the target serum urate level to be achieved (mg/dL) were 8.2 ± 0.9 and 6.9 ± 0.9, 8.4 ± 0.9 and 7.0 ± 1.0, 8.6 ± 1.0 and 7.3 ± 1.1, and 9.1 ± 1.2 and 7.8 ± 1.3 at stages 3, 4, 5, and 5D, respectively. The most frequently used maximal dosage of allopurinol was 100 mg/day at each stage. Benzbromarone was used in 52% of patients at stage 3, but only in 29%, 13%, and 5% of patients at stages 4, 5, and 5D, respectively. The most important reasons to treat AHU at CKD stages 3-5 were prevention of CKD progression (45%), CVE (33%), gout (18%), and urolithiasis (3%). Conclusions:  Most Japanese nephrologists treat AHU in predialysis CKD with an aim to prevent CKD progression or CVE mainly by allopurinol.
Authors:
Izaya Nakaya; Tamehachi Namikoshi; Yuki Tsuruta; Takeshi Nakata; Yugo Shibagaki; Yoshihiro Onishi; Shunichi Fukuhara;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-8
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1797     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.
Affiliation:
Department of Nephrology, Iwate Prefectural Central Hospital, Morioka, Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Department of Nephrology, Tokyo Women's Medical University Hospital, Tokyo, Department of Nephrology, Oita University Hospital, Oita, Division of Nephrology and Hypertension, St. Marianna University School of Medical Hospital, Kawasaki, Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto and Tokyo, and Department of Epidemiology and Healthcare Research, Graduate School of Medicine Kyoto University, Kyoto, Japan.
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