Patients with gout are at elevated risk for chronic kidney disease (CKD), a new study suggests.
Jasvinder A. Singh, MD, MPH, and John D. Cleveland, MD, from the University of Alabama at Birmingham, used a 5% random sample of Medicare claims to identify 1,699,613 people who met study eligibility criteria (76,309 with gout, 1,623,304 without gout). CKD developed in 17,903 individuals with gout and 150,162 without gout. The crude CKD incidence rate was higher among the individuals with gout vs those without gout (78.1 vs 15.6 cases per 1000 person-years). After adjusting for demographics, comorbidities, and use of cardiovascular and gout medications, gout was associated with a significant 3-fold higher risk for CKD, the investigators reported in BMC Nephrology.1
In addition, the risk for CKD associated with gout varied by certain patient characteristics. Gout was associated with a 2.2-fold increased risk for CKD among individuals with diabetes and a 3.5-fold increased among those without diabetes. Gout was also associated with a 2.4-fold increased risk for CKD among those with hypertension and 4.3-fold increased risk among those without hypertension.
“These observations improve our current understanding of renal disease in people with gout,” the authors concluded.
The new study adds to mounting evidence of a link between gout and development of CKD. Previously, in a retrospective study that matched 41,446 new gout cases to the same number of patients without gout,2 UK investigators found that the absolute rate of CKD stage 3 or higher was higher in the gout group than nongout group (28.6 vs 15.8 cases per 10,000 person-years). After adjusting for age, sex, comorbidities, and other variables, gout was associated with a significant 78% increased risk for CKD stage 3 or higher.
1. Singh JA, Cleveland JD. Gout is associated with a higher risk of chronic renal disease in older adults: a retrospective cohort study of U.S. Medicare population [published online March 15, 2019]. BMC Nephrol. doi: 10.1186/s12882-019-1274-5
2. 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.