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Gout can increase risk for end-stage renal disease

Patients with gout may be more likely to develop end-stage renal disease than the general population, according to recent results.

Researchers evaluated data from 656,108 patients collected in the 2000 Longitudinal Health Insurance Database in Taiwan, including 19,963 patients with gout. Participants were aged 20 years or older and not diagnosed with end-stage renal disease (ESRD), coronary heart disease or stroke at the time of enrollment, with a median of 8.0 years of follow-up. The study was conducted to determine whether patients with gout are at increased risk for ESRD.

By 2008, 2,377 patients (276 with gout; 2,101 without gout) had been diagnosed with ESRD, and 861 had died from the condition, including 77 with gout (27.9%) and 521 without gout (24.8%). The incidence of the illness was 1.73 per 1,000 patient-years in the gout group, compared with 0.41 in the nongout group (P<.001). A hazard ratio (HR) of 1.57 was determined for ESRD among patients with gout (95% CI, 1.38-1.79), and the adjusted HR for death was 0.95 among patients with ESRD and gout (95% CI, 0.74-1.26), with a similar ratio calculated for patients without gout.

Gout also was associated with a higher ESRD risk among patients without diabetes mellitus (DM) or hypertension (adjusted HR=2.00; 95% CI, 1.56-2.56). Among the 599,450 patients without DM or hypertension diagnoses, 1,132 developed ESRD, including 70 with gout (incidence rate 0.70 per 1,000 person-years) and 1,062 (incidence rate 0.22 per 1,000 person-years) without gout (P<.001).

“The current study demonstrated that gout independently increased the hazard of development of ESRD,” the researchers wrote, “with the magnitude of hazard in the gout-affected population being 57% higher than that in the general population. The risk was significant even among gout patients without DM or hypertension. These findings justify the careful monitoring of renal function in gout patients.”