April 28, 2015
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Patients with chronic kidney disease more likely to have gout

Patients with chronic kidney disease were more likely to develop gout later on, according to recently published research.

Researchers studied 2,159 men and 2,558 women enrolled in the Framingham Heart Study (FHS) cohort with data obtained from the National Heart, Lung, and Blood Institute (NHLBI) between 1948 and 2002. Patients with chronic kidney disease (CKD) or gout at baseline were excluded in the primary analysis.

Patients were followed biennially. Mean age at entry to the cohort was 45 years, and patient data including BMI, smoking status, presence of diabetes or hypertension and other data were collected. Median follow-up time was 36 years.

Gout was identified through patient records, including a physician’s diagnosis of gout or the use of a gout medication (allopurinol, probenecid or colchicine), and CKD was identified by a physician’s diagnosis. Serum uric acid (SUA) was measured at visits 1, 2, 3, 4 and 13; estimated glomerular filtration rate (eGFR) was available for five visits, and serum creatinine levels were available sporadically.

Incident CKD was observed in 220 men and 244 women in the follow-up period. Gout was observed in 231 men and 140 women in the cohort, with an overall incidence rate of 2.64 per 1,000 person years (3.89 in men, 1.73 in women). Among patients with CKD, the incidence of gout was 6.82 per 1,000 person-years overall and 2.43 per 1,000 person-years in participants without gout.

Unadjusted Cox regression models showed a hazard ratio (HR) of 2.04 for gout in patients with CKD. Multivariate regression models adjusted for age, sex, BMI, smoking status, alcohol use, hypertension and diabetes showed CKD was associated with HR of 2.09 for incident gout.

After inclusion of the 347 patients with CKD at baseline, the incidence rate of gout was 4.26 per 1,000 person years among patients with CKD and 2.43 per 1,000 person years in patients without CKD, according to the researchers. - by Shirley Pulawski

Disclosure s : Wang reports no financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.