Laterality, assessed using unenhanced computed tomography (CT) in patients with gout, may be useful to help characterize the presence of nephrolithiasis, according to results from a study published in the International Journal of Rheumatic Diseases.

Researchers conducted a cross-sectional study of 350 men with acute gout, defined according to the American College of Rheumatology 1977 criteria. The group of patients underwent helical CT imaging and were assessed for the presence of renal calculi. The investigators divided the patients into 3 separate groups: unilateral, bilateral, and non-stone carriers. The links between nephrolithiasis and renal function, serum urate level, and uric acid metabolism were examined in these patients.

After statistical analysis, the researchers identified renal calculi in 108 (31%) study participants, which included 50 and 58 patients in the unilateral and bilateral groups, respectively. In addition, they found that 59% of these patients had no prior history of urolithiasis.  

The investigators also reported that serum creatinine, serum urate, and uric acid metabolism (P <.001, P =.001, P =.043, respectively) were significantly increased, while estimated glomerular filtration rate (P =.039) was significantly decreased in the bilateral group vs the non-stone group.

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“There have been no previous reports on the laterality of nephrolithiasis in gout. The present investigation clarified that more than half of all gout patients with kidney stone(s) were bilateral and multiple stone carriers,” the researchers wrote.

“More studies will be required for better identification of the CT features of nephrolithiasis,” they concluded.

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Reference

Shimizu T, Hori H, Umeyama M, Shimizu K. Characteristics of gout patients according to the laterality of nephrolithiasis: A cross-sectional study using helical computed tomography [published online November 28, 2018]. Int J Rheum Dis. doi: 10.1111/1756-185X.13443