Gout is associated with elevated risk of chronic kidney disease (CKD) progression, according to the findings of a study published in BMJ Open.
The retrospective matched cohort study analysed UK Clinical Practice Research Datalink data for 68,897 patients with gout and 554 964 matched patients without gout. Patients were aged ≥18 years, registered at UK practices, had ≥12 months of clinical data and had data linked with Hospital Episode Statistics. Patients with a history of advanced CKD, juvenile gout, cancer, HIV, tumour lysis syndrome, Lesch-Nyhan syndrome or familial Mediterranean fever were excluded.
The incidence of advanced CKD incidence was higher for patients with gout (8.54 [95% CI, 8.26-8.83] per 1000 patient-years) versus without gout (4.08 [95% CI, 4.00-4.16] per 1000 patient-years). After adjustment, gout was associated with an increased risk of advanced CKD (HR, 1.29; 95% CI, 1.23-1.35).
The association was strongest for end-stage kidney disease (HR, 2.13; 95% CI 1.73-2.61) and was present for estimated glomerular filtration rate <10 mL/min/1.73 m² (HR, 1.45; 95% CI, 1.30-1.61) and serum creatinine doubling (HR, 1.13; 95% CI, 1.08-1.19) but not for CKD-associated death (HR, 1.14; 95% CI, 0.99-1.31).
The association of gout with advanced CKD was replicated in propensity-score matched analysis (HR, 1.23; 95% CI, 1.17-1.29) and when the analysis was limited to patients with incident gout (HR, 1.28; 95% CI, 1.22-1.35).
The authors call for future studies to investigate whether controlling gout is protective and reduces CKD risk.
