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char = l;code = 108
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char = s;code = 115
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char = ;code = 32
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char = ;code = 32
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char = n;code = 110
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char = u;code = 117
char = r;code = 114
char = v;code = 118
char = e;code = 101
char = y;code = 121
char = .;code = 46
result sql = Management of asymptomatic hyperuricaemia in patients with chronic kidney disease by Japanese nephrologists: a questionnaire survey.
Management of asymptomatic hyperuricaemia in patients with chronic kidney disease by Japanese nephrologists: a questionnaire survey.
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char = e;code = 101
char = r;code = 114
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char = c;code = 99
char = a;code = 97
char = e;code = 101
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char = i;code = 105
char = a;code = 97
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char = ;code = 32
char = k;code = 107
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char = s;code = 115
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char = a;code = 97
char = r;code = 114
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char = e;code = 101
char = n;code = 110
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char = s;code = 115
char = ;code = 32
char = (;code = 40
char = C;code = 67
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char = E;code = 69
char = );code = 41
char = .;code = 46
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char = a;code = 97
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char = ,;code = 44
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char = n;code = 110
char = l;code = 108
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char = ;code = 32
char = 4;code = 52
char = %;code = 37
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = r;code = 114
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char = e;code = 101
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char = m;code = 109
char = a;code = 97
char = t;code = 116
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char = o;code = 111
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char = t;code = 116
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = t;code = 116
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char = e;code = 101
char = d;code = 100
char = ;code = 32
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char = a;code = 97
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char = a;code = 97
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char = ;code = 32
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char = e;code = 101
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char = a;code = 97
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char = i;code = 105
char = c;code = 99
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char = u;code = 117
char = r;code = 114
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char = a;code = 97
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char = a;code = 97
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char = U;code = 85
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char = a;code = 97
char = r;code = 114
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char = f;code = 102
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char = ;code = 32
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char = o;code = 111
char = w;code = 119
char = ;code = 32
char = J;code = 74
char = a;code = 97
char = p;code = 112
char = a;code = 97
char = n;code = 110
char = e;code = 101
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char = e;code = 101
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char = b;code = 98
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char = d;code = 100
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char = d;code = 100
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char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = n;code = 110
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = A;code = 65
char = H;code = 72
char = U;code = 85
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = C;code = 67
char = K;code = 75
char = D;code = 68
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = .;code = 46
char = <;code = 60
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char = <;code = 60
char = b;code = 98
char = r;code = 114
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char = <;code = 60
char = b;code = 98
char = >;code = 62
char = M;code = 77
char = E;code = 69
char = T;code = 84
char = H;code = 72
char = O;code = 79
char = D;code = 68
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
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char = b;code = 98
char = >;code = 62
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char = e;code = 101
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = A;code = 65
char = H;code = 72
char = U;code = 85
char = ;code = 32
char = i;code = 105
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char = C;code = 67
char = K;code = 75
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char = a;code = 97
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char = m;code = 109
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char = w;code = 119
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char = o;code = 111
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char = 1;code = 49
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char = 0;code = 48
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char = e;code = 101
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char = ;code = 32
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char = g;code = 103
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = 3;code = 51
char = -;code = 45
char = 5;code = 53
char = ;code = 32
char = s;code = 115
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = l;code = 108
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ,;code = 44
char = ;code = 32
char = b;code = 98
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = f;code = 102
char = e;code = 101
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = n;code = 110
char = e;code = 101
char = p;code = 112
char = h;code = 104
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 3;code = 51
char = %;code = 37
char = );code = 41
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = d;code = 100
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = A;code = 65
char = H;code = 72
char = U;code = 85
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = C;code = 67
char = K;code = 75
char = D;code = 68
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 5;code = 53
char = D;code = 68
char = ;code = 32
char = s;code = 115
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = l;code = 108
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = m;code = 109
char = ;code = 32
char = u;code = 117
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = r;code = 114
char = t;code = 116
char = ;code = 32
char = u;code = 117
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = -;code = 45
char = l;code = 108
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = p;code = 112
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = a;code = 97
char = r;code = 114
char = g;code = 103
char = e;code = 101
char = t;code = 116
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = m;code = 109
char = ;code = 32
char = u;code = 117
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = c;code = 99
char = h;code = 104
char = i;code = 105
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = (;code = 40
char = m;code = 109
char = g;code = 103
char = /;code = 47
char = d;code = 100
char = L;code = 76
char = );code = 41
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = 8;code = 56
char = .;code = 46
char = 2;code = 50
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 0;code = 48
char = .;code = 46
char = 9;code = 57
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 6;code = 54
char = .;code = 46
char = 9;code = 57
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 0;code = 48
char = .;code = 46
char = 9;code = 57
char = ,;code = 44
char = ;code = 32
char = 8;code = 56
char = .;code = 46
char = 4;code = 52
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 0;code = 48
char = .;code = 46
char = 9;code = 57
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 7;code = 55
char = .;code = 46
char = 0;code = 48
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 1;code = 49
char = .;code = 46
char = 0;code = 48
char = ,;code = 44
char = ;code = 32
char = 8;code = 56
char = .;code = 46
char = 6;code = 54
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 1;code = 49
char = .;code = 46
char = 0;code = 48
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 7;code = 55
char = .;code = 46
char = 3;code = 51
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 1;code = 49
char = .;code = 46
char = 1;code = 49
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 9;code = 57
char = .;code = 46
char = 1;code = 49
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 1;code = 49
char = .;code = 46
char = 2;code = 50
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 7;code = 55
char = .;code = 46
char = 8;code = 56
char = ;code = 32
char = &;code = 38
char = #;code = 35
char = 1;code = 49
char = 7;code = 55
char = 7;code = 55
char = ;;code = 59
char = ;code = 32
char = 1;code = 49
char = .;code = 46
char = 3;code = 51
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = 3;code = 51
char = ,;code = 44
char = ;code = 32
char = 4;code = 52
char = ,;code = 44
char = ;code = 32
char = 5;code = 53
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 5;code = 53
char = D;code = 68
char = ,;code = 44
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = p;code = 112
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = y;code = 121
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = x;code = 120
char = i;code = 105
char = m;code = 109
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = d;code = 100
char = o;code = 111
char = s;code = 115
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = 1;code = 49
char = 0;code = 48
char = 0;code = 48
char = ;code = 32
char = m;code = 109
char = g;code = 103
char = /;code = 47
char = d;code = 100
char = a;code = 97
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = e;code = 101
char = a;code = 97
char = c;code = 99
char = h;code = 104
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = .;code = 46
char = ;code = 32
char = B;code = 66
char = e;code = 101
char = n;code = 110
char = z;code = 122
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = a;code = 97
char = r;code = 114
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 5;code = 53
char = 2;code = 50
char = %;code = 37
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 3;code = 51
char = ,;code = 44
char = ;code = 32
char = b;code = 98
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 9;code = 57
char = %;code = 37
char = ,;code = 44
char = ;code = 32
char = 1;code = 49
char = 3;code = 51
char = %;code = 37
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 5;code = 53
char = %;code = 37
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = 4;code = 52
char = ,;code = 44
char = ;code = 32
char = 5;code = 53
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 5;code = 53
char = D;code = 68
char = ,;code = 44
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = p;code = 112
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = y;code = 121
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = i;code = 105
char = m;code = 109
char = p;code = 112
char = o;code = 111
char = r;code = 114
char = t;code = 116
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = A;code = 65
char = H;code = 72
char = U;code = 85
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = C;code = 67
char = K;code = 75
char = D;code = 68
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = 3;code = 51
char = -;code = 45
char = 5;code = 53
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = C;code = 67
char = K;code = 75
char = D;code = 68
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = g;code = 103
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = 4;code = 52
char = 5;code = 53
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = C;code = 67
char = V;code = 86
char = E;code = 69
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = 3;code = 51
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = g;code = 103
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = (;code = 40
char = 1;code = 49
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = u;code = 117
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = i;code = 105
char = a;code = 97
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = %;code = 37
char = );code = 41
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = C;code = 67
char = O;code = 79
char = N;code = 78
char = C;code = 67
char = L;code = 76
char = U;code = 85
char = S;code = 83
char = I;code = 73
char = O;code = 79
char = N;code = 78
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = M;code = 77
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = J;code = 74
char = a;code = 97
char = p;code = 112
char = a;code = 97
char = n;code = 110
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = n;code = 110
char = e;code = 101
char = p;code = 112
char = h;code = 104
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = A;code = 65
char = H;code = 72
char = U;code = 85
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = -;code = 45
char = d;code = 100
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = y;code = 121
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = C;code = 67
char = K;code = 75
char = D;code = 68
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = i;code = 105
char = m;code = 109
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = C;code = 67
char = K;code = 75
char = D;code = 68
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = g;code = 103
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = C;code = 67
char = V;code = 86
char = E;code = 69
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = b;code = 98
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = .;code = 46
result sql = AIM : Hyperuricaemia is associated with chronic kidney disease (CKD) progression and cardiovascular events (CVE). In a US study, only 4% of rheumatologists initiated urate-lowering therapy in patients with asymptomatic hyperuricaemia (AHU). The present study aimed to clarify how Japanese board-certified nephrologists manage AHU in CKD patients.

METHODS : Questionnaires on management of AHU in CKD stage 3 or more were mailed to 1500 Japanese board-certified nephrologists, excluding paediatricians and urologists, randomly selected from the directory of the Japanese Society of Nephrology (n = 2976).

RESULTS : Five hundred and ninety-five nephrologists (40%) responded. Most nephrologists (84-89%) recommended that AHU in patients in CKD stages 3-5 should be treated, but fewer nephrologists (63%) recommended that AHU in patients of CKD stage 5D should be treated. The serum urate level to start urate-lowering therapy and the target serum urate level to be achieved (mg/dL) were 8.2 ± 0.9 and 6.9 ± 0.9, 8.4 ± 0.9 and 7.0 ± 1.0, 8.6 ± 1.0 and 7.3 ± 1.1, and 9.1 ± 1.2 and 7.8 ± 1.3 at stages 3, 4, 5 and 5D, respectively. The most frequently used maximal dosage of allopurinol was 100 mg/day at each stage. Benzbromarone was used in 52% of patients at stage 3, but only in 29%, 13% and 5% of patients at stages 4, 5 and 5D, respectively. The most important reasons to treat AHU at CKD stages 3-5 were prevention of CKD progression (45%), CVE (33%), gout (18%) and urolithiasis (3%).

CONCLUSION : Most Japanese nephrologists treat AHU in pre-dialysis CKD with an aim to prevent CKD progression or CVE mainly by allopurinol.

Publication: Nephrology (Carlton) 2011 Jul ;16(5)::518-21. :doi: 10.1111/j.1440-1797.2011.01446.x.
Publication Date: 2011 Jul
Study Author(s): Nakaya, Izaya;Namikoshi, Tamehachi;Tsuruta, Yuki;Nakata, Takeshi;Shibagaki, Yugo;Onishi, Yoshihiro;Fukuhara, Shunichi;School of Designing Clinical Study for Nephrologists and Dialysis Physicians;
Institution: Department of Nephrology, Iwate Prefectural Central Hospital, Morioka, Japan. [email protected]
Shortcut link to this study:
AIM : Hyperuricaemia is associated with chronic kidney disease (CKD) progression and cardiovascular events (CVE). In a US study, only 4% of rheumatologists initiated urate-lowering therapy in patients with asymptomatic hyperuricaemia (AHU). The present study aimed to clarify how Japanese board-certified nephrologists manage AHU in CKD patients.

METHODS : Questionnaires on management of AHU in CKD stage 3 or more were mailed to 1500 Japanese board-certified nephrologists, excluding paediatricians and urologists, randomly selected from the directory of the Japanese Society of Nephrology (n = 2976).

RESULTS : Five hundred and ninety-five nephrologists (40%) responded. Most nephrologists (84-89%) recommended that AHU in patients in CKD stages 3-5 should be treated, but fewer nephrologists (63%) recommended that AHU in patients of CKD stage 5D should be treated. The serum urate level to start urate-lowering therapy and the target serum urate level to be achieved (mg/dL) were 8.2 ± 0.9 and 6.9 ± 0.9, 8.4 ± 0.9 and 7.0 ± 1.0, 8.6 ± 1.0 and 7.3 ± 1.1, and 9.1 ± 1.2 and 7.8 ± 1.3 at stages 3, 4, 5 and 5D, respectively. The most frequently used maximal dosage of allopurinol was 100 mg/day at each stage. Benzbromarone was used in 52% of patients at stage 3, but only in 29%, 13% and 5% of patients at stages 4, 5 and 5D, respectively. The most important reasons to treat AHU at CKD stages 3-5 were prevention of CKD progression (45%), CVE (33%), gout (18%) and urolithiasis (3%).

CONCLUSION : Most Japanese nephrologists treat AHU in pre-dialysis CKD with an aim to prevent CKD progression or CVE mainly by allopurinol.
PMID: 21303423

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