Presence of gout linked to lower likelihood of kidney transplant wait-listing
Key takeaways:
- At 3 years, patients on hemodialysis who developed gout had a 6% lower likelihood of being wait-listed for a kidney transplant.
- Patients with gout had a 43% higher likelihood of death.
BOSTON — Among patients on hemodialysis, those who developed gout were 6% less likely to be wait-listed for a kidney transplant than those without gout, according to data presented at the National Kidney Foundation Spring Clinical Meetings.
“The main takeaway from this is one of the limiting factors for transplant is having gout. Also, if a patient is on dialysis or has kidney failure [and] they have gout, they are less likely to be listed for kidney transplant,” Sandesh Parajuli, MBBS, associate professor in the division of nephrology in the department of medicine at the University of Wisconsin in Madison, told Healio.
Parajuli and colleagues analyzed data from the United States Renal Data System on 180,117 Medicare recipients aged 18 to 80 years who started hemodialysis between 2016 and 2019 and survived for at least 90 days. Patients were followed until they were wait-listed for a kidney transplant or died or the study ended on Dec. 31, 2021. The researchers used the Fine-Gray proportional subdistribution hazard model to include death as a competing risk.
Mean follow-up time was 2.3 years, during which 18% of patients developed gout. Older age, male sex, Asian race, obesity and cardiovascular comorbidities were more common among the patients with gout.
At 3 years, patients on hemodialysis who developed gout had a 6% lower likelihood than those without gout of being wait-listed for a kidney transplant (adjusted HR = 0.94; 95% CI, 0.88-0.98) and a 43% higher likelihood of death (aHR = 1.43; 95% CI, 1.4-1.45).
Presence of gout may create barriers to transplant wait-listing, such as worse health resulting from gout-related inflammation, more hospitalizations and urgent care visits, a perception of frailty and other system-level barriers, according to the researchers.
“Gout as such is a multisystem disease, it’s not the only [condition] a patient with gout has. They may have other comorbid conditions [that may limit their access to kidney transplantation],” Parajuli said.
For more information:
Sandesh Parajuli, MBBS, can be reached at sparajuli@medicine.wisc.edu.
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Parajuli S, et al. Abstract G-574. Presented at: NKF Spring Clinical Meetings; April 9-13, 2025; Boston.