“…Furthermore, as some comorbidities such as chronic heart failure and diabetes mellitus are less influenced by SUA levels [47], UTL would not be favorable to them. In spite of UA infusion improving endothelial function [102], quickly lowering SUA could induce an acute gout flare [82], cardiovascular events [103], nerve dysfunction [104], the risk of all-cause death in hemodialysis [61], vertebral fracture [105], or heart failure in patients [106]. Additionally, it has been reported that in patients with gout SUA is usually lower during acute gouty attacks than during intercritical periods [11] possibly due to the slow systemic inflammatory response.…”