Uric acid is the final product of purine metabolism. Hyperuricemia may result from increased production or reduced excretion of uric acid. Hyperuricemia represents a risk for gouty arthritis. In this condition, monosodium urate (MSU) crystals reach a concentration above the solubility threshold and lead to gouty arthritis after precipitation in the joints. Gouty arthritis is the most common type of inflammatory arthritis in adults. On the other hand, chronic renal disease has become a global public health problem associated with increased morbidity and mortality. Elevated serum uric acid is a common finding in patients with chronic kidney disease. Furthermore, chronic kidney disease represents the most common and independent risk factor for gouty arthritis. Patients with gouty arthritis have an increased prevalence of chronic kidney disease. Gouty arthritis is a potentially treatable condition. Therapeutic options include non-pharmacological (education and nutritional counseling) and pharmacological (non-steroidal anti-inflammatory drugs, glucocorticoids, colchicine, and IL-1 antagonists) approaches. Treatment of gouty arthritis in patients with renal disease is a challenging task, because the use of non-steroidal anti-inflammatory drugs as well as colchicine requires special care and lower doses of allopurinol should be administered.