Liang Xiao, Wei Lu, Junli Wang, Shengyou Yu
Research into pediatric hyperuricemia remains nascent yet is rapidly gaining momentum. Our roadmap highlights four critical frontiers: elucidating developmental-stage-specific pathological mechanisms, establishing validated diagnostic thresholds, evaluating the long-term safety and efficacy of both pharmacological and non-pharmacological interventions, and defining strategies for lifelong management to mitigate adult-onset complications. We advocate for enhanced international and interdisciplinary collaboration as the cornerstone for accelerating progress in this vital field.
BACKGROUND: Pediatric hyperuricemia has emerged as a significant global health concern, intricately linked to the early pathogenesis of metabolic syndrome, cardiovascular disease, and chronic kidney disease. Despite extensive research in adults, critical gaps persist in our understanding of its unique pathophysiology, age-specific diagnostic criteria, and evidence-based management strategies in children. This study aims to provide a comprehensive, quantitative assessment of the global research landscape on pediatric hyperuricemia, identify pivotal thematic foci, and map emerging frontiers to guide future scientific inquiry and clinical translation.
METHODS: We conducted a systematic bibliometric and visual analysis of all relevant articles and reviews indexed in the Web of Science Core Collection (WoS CC) from inception to December 20, 2024. Data were synthesized using VOSviewer, CiteSpace, and the Bibliometrix R package to construct collaboration networks, perform co-citation analyses, and track keyword evolution.
RESULTS: Our analysis identified 189 publications, revealing a trajectory of fluctuating but overall increasing scholarly attention. China (n=47) and the United States (n=43) were the most prolific contributors, with St. Jude Children's Research Hospital and Harvard University leading institutional output. Authors Simonetta Genovesi and Marco Giussani were the most productive. Keyword co-occurrence analysis delineated three dominant research clusters: (I) core clinical management ("hyperuricemia", "allopurinol", "rasburicase"); (II) cardiometabolic comorbidities ("obesity", "hypertension", "metabolic syndrome"); and (III) epidemiological and risk factor profiling ("children", "uric acid", "prevalence"). Notably, recent years have witnessed an emergent focus on long-term sequelae, including "chronic kidney disease" and "acute kidney injury".
CONCLUSIONS: Research into pediatric hyperuricemia remains nascent yet is rapidly gaining momentum. Our roadmap highlights four critical frontiers: elucidating developmental-stage-specific pathological mechanisms, establishing validated diagnostic thresholds, evaluating the long-term safety and efficacy of both pharmacological and non-pharmacological interventions, and defining strategies for lifelong management to mitigate adult-onset complications. We advocate for enhanced international and interdisciplinary collaboration as the cornerstone for accelerating progress in this vital field.