Renal effects of uric acid: hyperuricemia and hypouricemia

Korean J Intern Med. 2020 Nov;35(6):1291-1304. doi: 10.3904/kjim.2020.410. Epub 2020 Sep 9.


The prevalence of chronic kidney disease (CKD) is increasing worldwide. Although hyperuricemia has been associated with CKD in many studies, it remains controversial whether this is the cause or the result of decreased renal function. Recent observational studies of healthy populations and patients with CKD have reported that uric acid (UA) has an independent role in the development or progression of CKD. Experimental studies have shown several potential mechanisms by which hyperuricemia may cause or promote CKD. However, other reports have indicated an association between hypouricemia and CKD. This opposing effect is hypothesized to occur because UA is a major antioxidant in human plasma and is associated with oxidative stress. In this article, we discuss the potential association between UA imbalance and CKD and how they can be treated.

Keywords: Hyperuricemia; Hypouricemia; Kidney; Uric acid.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Child
  • Disease Progression
  • Female
  • Humans
  • Hyperuricemia / blood*
  • Kidney / pathology*
  • Renal Insufficiency, Chronic
  • Renal Tubular Transport, Inborn Errors / blood*
  • Uric Acid / adverse effects*
  • Uric Acid / blood*
  • Urinary Calculi / blood*


  • Biomarkers
  • Uric Acid

Supplementary concepts

  • Renal hypouricemia