Contents

for authors

Cart

quick search

Journal Info

  • Editor in Chief: Prof. Giovanni Gambaro
  • Co-Editor: Benedetta Bussolati
  • Current issue: Vol. 26 issue Suppl. 22 , 2013 (November-December)

Contents

for authors

Cart

Your cart is empty

View cart

quick search

Vol. 26 - Issue 4 (July-August 2013)

Managing new-onset gout in pediatric renal transplant recipients: when, how, to what extent

Managing new-onset gout in pediatric renal transplant recipients: when, how, to what extent

J Nephrol 2013; 26(4): 624 - 628

Article Type: REVIEW

DOI:10.5301/jn.5000204

Authors

Farahnak Assadi

Abstract

Hyperuricemia and gout are common among adult renal transplant recipients, but it is rarely reported following pediatric renal transplantations. Treating gout in pediatric kidney transplant recipients presents clinical challenges to the management of both immunosuppressive regimen and hyperuricemia for their effects on serum uric acid levels, renal function and drug interactions. Most renal transplant recipients have a relative impairment of renal clearance of urate due to abnormalities in renal transport, explaining the association of hyperuricemia and decreased glomerular filtration rate. Risk factors for the development of gout include impaired renal function, hypertension, heart failure and diabetes mellitus. Calcineurin inhibitors, particularly cyclosporine, are the most important risk factor for gout in transplant recipients and should not be used in pediatric renal transplant recipients. Diuretic therapy increases the risk of gout by causing extracellular volume contraction with consequent enhancement of proximal tubular reabsorption. Corticosteroids are increasingly replacing nonsteroidal antiinflammatory drugs and colchicine for the treatment of acute gout flares because they have little effect on kidney function. Proper management is aimed at lowering serum uric acid level below 6.0 mg/dL with xanthine oxidase inhibitors such as allopurinol or febuxostat. Allopurinol and mycophenolate mofetil are safer to use in combination than are allopurinol and azathioprine. Febuxostat is an alternative to allopurinol in patients with allopurinol intolerance or hypersensitivity. Pegloticase is indicated for patients with severe gout in whom allopurinol and febuxostat have not been effective or tolerated.

Article History

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

Authors

  • Assadi, Farahnak [PubMed] [Google Scholar]
    Section of Nephrology, Department of Pediatrics, Rush University Medical Center, Chicago, Illinois - USA

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • If you are not a Subscriber you may:
  • Subscribe to this journal

    Unlimited access to all our archives, 24 hour a day, every day of the week.

    Article price: Eur 36.00

    You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.

  • Claim online access

    If you hold a Society membership and you have never accessed the website claim online access to receive your log in credentials

No supplementary material is available for this article.