This is a very controversial topic. Some evidence suggests that reduced kidney function leads to elevated uric acid levels whereas other data suggest uric acid leads to reduced kidney function.

I tend to be in the former camp; I have not seen any convincing data that lowering uric acid acid leads to prevention of renal function loss. Furthermore, there are risks to taking medication to lower uric acid. Instead, in my practice, I only suggest lowering uric acid with medication in those with recurrent gout, in those with extremely high levels or in patients at risk for tumor lysis syndrome. Alkaline diets are a fad and do not have any role in disease prevention in my opinion.

Dr. Jordan Weinstein