The observation that hyperuricemia can predict the development of CKD has led to the hypothesis that lowering serum uric acid in hyperuricemic individuals might reduce both the development and progression of chronic kidney disease (CKD). Nevertheless, the CKD-FIX trial reported that allopurinol treatment, when prescribed irrespective of serum uric acid levels, did not slow progression of CKD.1 Although the trial can be criticized for not including individuals with a history of gout (who might be expected to have the most benefit) and including normouricemic individuals (who would be expected to show the least benefit), its results suggest that indiscriminate treatment of CKD with allopurinol is likely not beneficial.