Consensus Statement on the Management of Patients With Asymptomatic Hyperuricemia in General Medical Practice

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Abstract

Hyperuricemia is a condition characterized by an increase of serum uric acid level above 360 µmol/L. It is known that high serum uric acid levels are not only the condition for the etiopathogenesis of gout but also an important risk factor for the development and progression of cardiovascular diseases, kidney and liver pathologies, type 2 diabetes, and others. This makes hyperuricemia a relevant issue in general therapeutic practice. Despite extensive evidence on the negative role of hyperuricemia in many internal organ diseases, the management strategy for patients with asymptomatic hyperuricemia in real clinical practice remains a subject of debate.

This resolution represents an interdisciplinary consensus of experts from Commonwealth of Independent States, based on current evidence-based medicine data and proprietary registries. The proposed algorithm emphasizes the importance of a personalized approach to the treatment of hyperuricemia, taking into account the severity of comorbid conditions and the level of cardiovascular risk. Step-by-step recommendations are provided for general practitioners, family doctors, and a wide range of specialists in both non-pharmacological and pharmacological urate-lowering therapy. These guidelines aim to improve the quality of medical care for patients at high risk of socially significant diseases occurring together with asymptomatic hyperuricemia.

About the authors

Oksana M. Drapkina

National Medical Research Center for Therapy and Preventive Medicine; Russian Society for the Prevention of Noncommunicable Diseases

Email: drapkina@bk.ru
ORCID iD: 0000-0002-4453-8430
SPIN-code: 4456-1297

MD, Dr. Sci. (Medicine), Professor, Academician of the RAS

Russian Federation, Moscow; Moscow

Vadim I. Mazurov

North-Western State Medical University named after I.I. Mechnikov

Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051
SPIN-code: 6823-5482

MD, Dr. Sci. (Medicine), Professor, Academician of the RAS, Honored Scientist of the Russian Federation

Russian Federation, Saint Petersburg

Martynov I. Martynov

Russian Scientific Medical Society of Internal Medicine; A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: anatmartynov@mail.ru
ORCID iD: 0000-0002-0783-488X
SPIN-code: 5271-3173

MD, Dr. Sci. (Medicine), Professor, Academician of the RAS

Russian Federation, Moscow; Moscow

Evgeny L. Nasonov

V.A. Nasonova Research Institute of Rheumatology

Email: nasonov@irramn.ru
ORCID iD: 0000-0002-1598-8360
SPIN-code: 5162-6484

MD, Dr. Sci. (Medicine), Professor, Academician of the RAS

Russian Federation, Moscow

Sergey A. Saiganov

North-Western State Medical University named after I.I. Mechnikov

Email: sergey.sayganov@szgmu.ru
ORCID iD: 0000-0001-8325-1937
SPIN-code: 2174-6400

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Aleksander M. Lila

V.A. Nasonova Research Institute of Rheumatology

Email: sokrat@irramn.ru
ORCID iD: 0000-0002-6068-3080
SPIN-code: 7287-8555

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the RAS

Russian Federation, Moscow

Roman A. Bashkinov

North-Western State Medical University named after I.I. Mechnikov

Email: bashkinov-roman@mail.ru
ORCID iD: 0000-0001-9344-1304
SPIN-code: 5169-5066

MD

Russian Federation, Saint Petersburg

Irina N. Bobkova

I.M. Sechenov First Moscow State Medical University; Scientific Society of Nephrologists of Russia

Email: irbo.mma@mail.ru
ORCID iD: 0000-0002-8007-5680
SPIN-code: 4217-4514

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Chokan T. Baimukhamedov

Shymkent Medical Centre of Joint Diseases; Kazakh College of Rheumatology

Email: shocan@mail.ru
ORCID iD: 0000-0003-3261-1036

MD, Dr. Sci. (Medicine), Professor

Kazakhstan, Shymkent; Almaty

Inna Z. Gaydukova

North-Western State Medical University named after I.I. Mechnikov

Email: ubp1976@list.ru
ORCID iD: 0000-0003-3500-7256
SPIN-code: 3083-7996

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Nadir I. Huseynov

Azerbaijan Medical University; Rheumatological Center “AYAN”

Email: mucosnadir@list.ru
ORCID iD: 0000-0002-6052-1727

MD, Dr. Sci. (Medicine), Professor

Azerbaijan, Baku; Baku

Dmitry V. Duplyakov

Samara State Medical University; Samara Regional Clinical Cardiology Dispensary

Email: duplyakov@yahoo.com
ORCID iD: 0000-0002-6453-2976
SPIN-code: 5665-9578

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Samara; Samara

Maxim S. Eliseev

V.A. Nasonova Research Institute of Rheumatology

Email: elicmax@rambler.ru
ORCID iD: 0000-0003-1191-5831
SPIN-code: 2524-7320

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Abdimutalib T. Mamasaidov

Osh State University; Association of the Kyrgyz Republic Rheumatologists

Email: oshksma@yandex.com
ORCID iD: 0000-0003-2285-5598
SPIN-code: 9298-5738

MD, Dr. Sci. (Medicine), Professor

Kyrgyzstan, Osh; Bishkek

Natalia A. Martusevich

Belarusian State Medical University

Email: martusevitch@mail.ru
SPIN-code: 2273-9705

MD, Cand. Sci. (Medicine), Professor

Belarus, Minsk

Khilola T. Mirakhmedova

Tashkent Medical Academy

Email: hilola_mirahmedova@mail.ru
ORCID iD: 0000-0003-1025-8825

MD, Dr. Sci. (Medicine), Assistant Professor

Uzbekistan, Tashkent

Ilkhom T. Murkamilov

I.K. Akhunbaev Kyrgyz state medical academy; Kyrgyzstan Society of Specialists in Chronic Kidney Disease

Email: murkamilov.i@mail.ru
ORCID iD: 0000-0001-8513-9279
SPIN-code: 4650-1168

MD, Dr. Sci. (Medicine), Assistant Professor

Kyrgyzstan, Bishkek; Bishkek

Dildora A. Nabieva

Tashkent Medical Academy

Email: dil_nab@mail.ru
ORCID iD: 0000-0002-7879-1522

MD, Dr. Sci. (Medicine), Assistant Professor

Uzbekistan, Tashkent

Vera A. Nevzorova

Pacific State Medical University

Email: nevzorova@inbox.ru
ORCID iD: 0000-0002-0117-0349
SPIN-code: 5232-0247

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Vladivostok

Olga D. Ostroumova

Russian Medical Academy of Continuing Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-0795-8225
SPIN-code: 3910-6585

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Vladimir V. Salukhov

Kirov Military Medical Academy

Email: vlasaluk@yandex.ru
ORCID iD: 0000-0003-1851-0941
SPIN-code: 4531-6011

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Galymzhan A. Togizbayev

Kazakh College of Rheumatology

Email: g.togizbayev@gmail.com
ORCID iD: 0000-0002-7842-1871

MD, Dr. Sci. (Medicine), Professor

Kazakhstan, Almaty

Evgeny A. Trofimov

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: evgeniy.trofimov@szgmu.ru
ORCID iD: 0000-0003-3236-4485
SPIN-code: 4358-1663

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Iurii S. Khalimov

Pavlov First Saint Petersburg State Medical University

Email: yushkha@gmail.com
ORCID iD: 0000-0002-7755-7275
SPIN-code: 7315-6746

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Anna I. Chesnikova

Rostov State Medical University

Email: rostov-ossn@yandex.ru
ORCID iD: 0000-0002-9323-592X
SPIN-code: 9677-0932

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Rostov-on-Don

Sergey S. Yakushin

Ryazan State Medical University named after academician I.P. Pavlov

Email: prof.yakushin@gmail.com
ORCID iD: 0000-0002-1394-3791
SPIN-code: 7726-7198

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ryazan

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2. Fig. 1. The proposed algorithm for managing patients with hyperuricemia. AH, arterial hypertension; UA, uric acid; MI, myocardial infarction; OA, osteoarthritis; AFCC, acute failure of cerebral circulation; RA, rheumatoid arthritis; DM, diabetes mellitus; CVR, cardiovascular risk; CKD, chronic kidney disease; KSD, kidney stone disease; CHF, chronic heart failure.

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