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Symptomatic Gout ULT CKD — ESENeph MCQ

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EasyChronic Kidney DiseaseSymptomatic Gout ULT CKDESENeph

A 48-year-old man with CKD G3b (eGFR 38) has persistently elevated urate at 580 umol/L. He has had 3 acute gout attacks in the past year and is now on Colchicine prophylaxis. According to KDIGO 2024, should urate-lowering therapy be started?

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Correct answer: B — Yes – KDIGO recommends urate-lowering intervention for CKD patients with symptomatic hyperuricaemia (gout)

KDIGO 2024 recommends (1C) that people with CKD and symptomatic hyperuricaemia should be offered urate-lowering intervention. This patient has recurrent gout attacks (symptomatic) and should be started on Allopurinol (starting low dose, 100 mg, titrating slowly with renal monitoring) or Febuxostat. Crucially, KDIGO distinguishes symptomatic from asymptomatic hyperuricaemia – ULT is NOT recommended for asymptomatic hyperuricaemia to slow CKD progression (2D).

Reference: KDIGO 2024 – CKD Guideline