Does Gout Increase the Risk for Chronic Kidney Disease?

Researchers have previously identified risk factors for chronic kidney disease (CKD) including family history, hypertension, diabetes mellitus, and smoking.¹ Citing an increasing interest among the scientific community in the role of novel risk factors, a team of investigators set out to evaluate the association between gout and CKD. Their findings were published in BMJ Open.²

Study Investigates Link Between Gout and CKD

Drawing from the UK Clinical Practice Research Datalink, the researchers analyzed data from 68,897 patients with gout and 554,964 matched individuals without the condition. Both groups were followed for an average of 3.68 years.²

Patients were aged ≥18 years, registered at practices in the United Kingdom, and had ≥12 months of clinical data linked with Hospital Episode Statistics. Patients with a history of advanced CKD, juvenile gout, cancer, HIV, tumor lysis syndrome, Lesch Nyhan syndrome, or familial Mediterranean fever were excluded.

Advanced CKD was defined as the first occurrence of:

• Dialysis, kidney transplant, diagnosis of end-stage kidney disease (ESKD), or stage 5 CKD
• Kidney function <10% of normal
• Doubling of serum creatinine from baseline
• Death associated with CKD

Gout Independently Associated With Risk for Advanced CKD

The investigators found that patients with gout were at a 29% greater risk for CKD and 210% increased risk for kidney failure compared with patients without the disease. The presence of gout was also associated with a 45% greater risk for an estimated glomerular filtration rate <10 mL/min/1.73 m² and a 13% increased risk for serum creatinine doubling.

The authors concluded that, while further research is necessary to determine whether adequate control of gout can reduce the risk of CKD progression, gout is independently associated with the risk of advanced CKD.

A Growing Body of Evidence

The researchers noted that their findings “add to the accumulating body of evidence that gout is an independent risk factor for kidney disease progression.”² One notable example was published in Arthritis Research & Therapy in 2018.

In that study, researchers matched 41,446 new gout cases with an identical number of patients without gout. They found that CKD stage ≥3 developed in 6694 patients with gout (16.2%) vs 3953 patients without the condition (9.5%) over a median 6-year follow-up period.³

References

1. Kazancioğlu R. Risk factors for chronic kidney disease: an update. Kidney Int Suppl. 2013;3(4):368-371.
2. Stack AG, Johnson ME, Blak B, et al. Gout and the risk of advanced chronic kidney disease in the UK health system: a national cohort study [published online August 28, 2019]. BMJ Open. doi: 10.1136/bmjopen-2019-031550
3. Roughley M, Sultan AA, Clarson L, et al. Risk of chronic kidney disease in patients with gout and the impact of urate lowering therapy: a population-based cohort study. Arthritis Res Ther. 2018;20(1):243.