Environmental and dietary triggers of hyperuricemia in chronic kidney disease: A cardiovascular perspective

An integrated approach is required to manage hyperuricemia in CKD. Lifestyle strategies, including reducing dietary fructose, limiting alcohol, and adopting plant-forward diets, may lower serum urate, while mitigating environmental exposures may help preserve renal function. Pharmacotherapy should be individualized based on comorbidities and risk profiles. Despite supportive mechanistic and observational evidence, randomized trials remain inconclusive, highlighting the need for further research to clarify the cardiovascular impact of urate-lowering therapies and their role in CKD populations. A comprehensive, multidisciplinary approach may help reduce risk factors associated with CKD progression and cardiovascular disease.