Drugs & Aging

, Volume 35, Issue 4, pp 263–273 | Cite as

Managing Gout in the Patient with Renal Impairment

  • Eliseo Pascual
  • Francisca Sivera
  • Mariano Andrés
Therapy in Practice


Hyperuricaemia is an independent risk factor for renal function decline. Evidence is emerging that urate-lowering therapy might be beneficial in subjects with renal impairment. We  review the association between renal impairment and gout, some of the related pathogenic processes and the possible impact of gout treatment on the progression of renal impairment. Nevertheless, the management of gout is more complex in the presence of chronic kidney disease. The main aim of gout therapy is to fully dissolve the urate crystals, thus curing the disease. Avoidance of attacks—prophylaxis—and their prompt treatment if they occur, along with accurate information to patients, completes the treatment strategy. This article provides a practical guide to managing gout in older patients and in those with renal impairment. We highlight the shortcomings in our current treatment options and strategies.



No funding was received for the preparation of this article.

Compliance with Ethical Standards

Conflict of interest

Eliseo Pascual has participated in the boards of Astra Zeneca, Menarini, Grunenthal and Pegloticase (unrelated to this article), and has received speaking fees from Astra Zeneca and Grunenthal (unrelated to this article). Mariano Andrés has received fees for participation in review activities such as data monitoring boards from Grunenthal and Astra-Zeneca, and has received support for travel from Menarini, Grunenthal and Astra-Zeneca. Francisca Sivera has received speaking fees from Menarini.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Hospital General Universitario de AlicanteAlicanteSpain
  2. 2.Universidad Miguel Hernández de ElcheAlicanteSpain
  3. 3.Hospital General Universitario EldaAlicanteSpain
  4. 4.Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL)AlicanteSpain

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