Chung TT, Yu KH, Kuo CF, et al. - A total of 5,860 incident gout patients at Chang Gung Memorial Hospital from 2012 to 2015 were recognized to examine the correlation between exposure to urate-lowering drugs (ULDs) and progression and recovery from chronic kidney disease (CKD). Regardless of the urate-lowering mechanism of action, one in nine patients exposed to ULDs had CKD progression. Gout patients were at great risk of renal deterioration even for those with a moderately preserved renal function probably because of their concomitant risk factors such as renal toxic medication and comorbidities. Among those exposed to allopurinol, febuxostat, and uricosuric agents, The risk of CKD progression was comparable, and this impact was constant across the patients with various stages of CKD at baseline. Moreover, CKD recovery was also prevalent among patients with CKD progression, among whom nearly three quarters had a betterment in renal function. Nevertheless, in comparison with the patients receiving allopurinol, those receiving febuxostat and uricosuric agents had a two-fold higher probability of recovery. Thus, CKD progression in gout patients was not an uncommon observation following the beginning of ULDs and renal function recovery was recognized in three-quarters of those who had CKD progression. Moreover, in patients exposed to febuxostat and uricosuric agents, CKD progression was less prevalent in comparison with those exposed to allopurinol, especially for those with existing CKD.