CRYSTAL DEPOSITION DISEASES: Edited by Hyon ChoiSerum uric acid and the risk of hypertension and chronic kidney diseaseFeig, Daniel I. Author Information Department of Pediatrics, Division of Nephrology, University of Alabama, Birmingham School of Medicine. Birmingham, Alabama, USA Correspondence to Daniel I. Feig, MD, PhD, University of Alabama, Birmingham, School of Medicine, Department of Pediatrics, Division of Nephrology, 1600 7th Ave South, Lowder Bldg 516, Birmingham, AL, USA. Tel: +1 205 638 9781; e-mail: [email protected] Current Opinion in Rheumatology: March 2014 - Volume 26 - Issue 2 - p 176-185 doi: 10.1097/BOR.0000000000000033 Buy Metrics Abstract Purpose of review To discuss the evolving data regarding uric acid as a potential cause of hypertension and progressive renal dysfunction and its clinical and research implications. Recent findings The potential mechanisms by which uric acid could cause vasoconstriction and a progressive ateriolopathy were established in animal models between 1999 and 2004. Since then, there has been a growing interest in the topic and numerous retrospective and prospective observational studies. The preponderance of data support the hypothesis that serum uric acid is a cause or exacerbating factor of hypertension and progressive kidney disease. Over the last couple of years clinical intervention trials, including randomized controlled trials in the young have supported this mechanistic role. Summary Current evidence supports the role of uric acid as marker and mediator of risk for both hypertension and progressive decline in renal function. Data on the impact of xanthine oxidase inhibitors or uricosurics on clinical hypertension and chronic kidney disease are suggestive but inconclusive. Considerably, more data will be required to determine if uric acid lowering therapy will become a mainstay of management in diseases other than gout and tumor lysis syndrome. © 2014 Lippincott Williams & Wilkins, Inc.