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Gout Patients at Risk of Kidney Failure

GOUT is a type of inflammation that is the result of the build up of uric acid in the joints, and causes significant pain and disability. The disease affects approximately 2.5% of the adult population and is often poorly managed. Previous studies have identified a higher burden of kidney disease, but until now, none had convincingly shown that gout can contribute to the development of kidney failure.

Involving >620,000 patients in the UK health system, a team from the University of Limerick, Limerick, Ireland, conducted one of the largest and most detailed studies into the relationship between gout and kidney disease. The researchers analysed clinical data from patients attending primary care centres from across the UK using the Clinical Research Practice Data Datalink (CPRD) database.

The risk of developing chronic kidney disease (CKD) was analysed in the gout patients (n=68,897), and this was compared to patients without gout (n=554,964). Advanced kidney disease was defined using four criteria: the need for dialysis or kidney transplant; failing kidney function to <10% of normal; doubling of serum creatinine from baseline; and death associated with CKD. Gout patients were followed up for a mean duration of 3.7 years.

Strikingly, it was discovered that patients afflicted with gout had a 29% higher risk of developing CKD than those without gout and 200% higher risk to develop kidney failure. Furthermore, short-term deterioration of kidney function was more likely to occur in gout patients.”While we always believed that high levels of uric acid might be bad for kidneys and that patients with gout may have a higher risk of kidney failure, we were quite surprised by the magnitude of the risk imposed by gout in these patients,” commented the study lead author Prof Austin Stack, Foundation Chair of Medicine at University of Limerick.

The representativeness of the study to patients who typically visit the general practice is thought to be high as a result of the use of the CPRD database, hopefully shedding light on this important relationship between gout and CKD. Prof Stack added that “the result of this new research suggests that gout may also play an important role in the progression of kidney disease. The identification of gout as a potential risk factor opens up new opportunities for the prevention of kidney disease and its consequences.”