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Asymptomatic Hyperuricaemia No ULT CKD — ESENeph MCQ

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EasyChronic Kidney DiseaseAsymptomatic Hyperuricaemia No ULT CKDESENeph

A 60-year-old man with CKD G3b is found to have elevated serum urate (620 umol/L) without gout symptoms. His GP wants to start Allopurinol to slow CKD progression. According to KDIGO 2024, is this indicated?

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Correct answer: E — No – KDIGO 2024 suggests NOT using agents to lower serum uric acid to delay CKD progression in asymptomatic hyperuricaemia (2D)

KDIGO 2024 specifically recommends against treating asymptomatic hyperuricaemia to slow CKD progression. The CKD-FIX trial (2020) and PERL trial (2020) showed no benefit of Allopurinol on eGFR decline in CKD patients with asymptomatic hyperuricaemia. This is an important change from older practice where empirical ULT was common. ULT IS recommended for symptomatic hyperuricaemia (gout) in CKD (1C). The distinction between symptomatic and asymptomatic is critical.

Reference: KDIGO 2024 – CKD Guideline; CKD-FIX Trial – NEJM 2020; PERL Trial – NEJM 2020