Kidney Research and Clinical Practice  https://doi.org/10.23876/j.krcp.19.007
Physicians’ perceptions of asymptomatic hyperuricemia in patients with chronic kidney disease: a questionnaire survey
Ran-hui Cha1 , Su Hyun Kim2 , Eun Hui Bae3 , Mina Yu4 , Beom Soon Choi5 , Hoon Young Choi6 , Sun Woo Kang7 , Jungho Shin2 , Sang Youb Han8 , Chul Woo Yang5 , Duk-Hee Kang9
1Department of Internal Medicine, National Medical Center, Seoul, Korea
2Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
3Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
4Department of Internal Medicine, Seonam Hospital, Seoul, Korea
5Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
6Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
7Department of Nephrology, Inje University Busan Paik Hospital, Busan, Korea
8Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
9Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
Correspondence to: Duk-Hee Kang
Division of Nephrology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, 260 Gonghang-daero, Gangseo-gu, Seoul 07804, Korea. E-mail: dhkang@ewha.ac.kr
Ran-hui Cha
Division of Nephrology, Department of Internal Medicine, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea. E-mail: reginaprayer@gmail.com
Received: January 13, 2019; Revised: March 15, 2019; Accepted: March 18, 2019; Published online: April 29, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Hyperuricemia is associated with the development and progression of chronic kidney disease (CKD) as well as cardiovascular diseases. However, there is no consistent recommendation regarding the treatment of asymptomatic hyperuricemia (AHU) in CKD patients. Here, we surveyed Korean physicians’ perceptions regarding the diagnosis and management of AHU in CKD patients.
Methods: Questionnaires on the management of AHU in CKD patients were emailed to regular members registered with the Korean Society of Nephrology.
Results: A total of 158 members answered the questionnaire. Among the respondents, 49.4%/41.1% were considered hyperuricemic in male CKD patients whereas 36.7%/20.9% were considered hyperuricemic in female CKD patients when defined by serum uric acid level over 7.0/8.0 mg/dL, respectively. A total of 80.4% reported treating AHU in CKD patients. The most important reasons to treat AHU in CKD patients were renal function preservation followed by cerebro-cardiac protection. Majority of respondents (59.5%) thought that uric acid-lowering agents (ULAs) were the most effective method for controlling serum uric acid levels. Approximately 80% chose febuxostat as the preferred medication. A total of 32.3% and 31.0%, respectively, initiated ULA treatment if the serumuric acid level was more than 8.0 or 9.0 mg/dL, respectively. In addition, 39.2% and 30.4% answered that target serum uric acid levels of less than 6.0 or 7.0 mg/dL, respectively, were appropriate. The two major hurdles to prescribing ULAs were concerns of adverse reactions and the existing lack of evidence (i.e., the absence of Korean guidelines).
Conclusions: Most Korean physicians treat AHU in CKD patients to prevent CKD progression and cerebrocardiovascular complications.
Keywords: Asymptomatic hyperuricemia, Chronic kidney disease, Survey, Treatment


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