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Chronic kidney disease and the risk of incident gout among middle-aged men: a seven-year prospective observational study.
Arthritis Rheum. 2013 Dec; 65(12):3271-8.AR

Abstract

OBJECTIVE

The kidney is the major organ that facilitates excretion of urate in humans. Surprisingly, few studies have assessed whether a reduced glomerular filtration rate (GFR) and/or kidney damage is associated with a higher incidence of gout, and this study was undertaken to address this question.

METHODS

Data from a 7-year followup of patients enrolled in the Multiple Risk Factor Intervention Trial, a primary prevention trial for cardiovascular disease among 12,866 men ages 35-57 years, were used for the present investigation. Presence of gout was determined by the study physicians from the original trial. Chronic kidney disease was defined using criteria similar to those proposed by the National Kidney Foundation. The Cox proportional hazards regression model was used to assess the association between gout and chronic kidney disease, after accounting for the effects of potential confounders.

RESULTS

Overall, there were 722 cases of physician- diagnosed incident gout over 76,602 person-years of followup. The standardized incidence ratio of gout among those with chronic kidney disease was 1,217 (95% confidence interval [95% CI] 1,191-1,244). The adjusted hazard ratio (HR) among those with chronic kidney disease was 1.61 (95% CI 1.60-1.61). Each standard deviation decline in the estimated GFR was associated with an HR of 1.43 (95% CI 1.35-1.51). Including the serum urate level, as well as the urate-chronic kidney disease interaction term, as variables in the second analysis did not attenuate the HR. Proteinuria and hematuria, two markers of kidney damage, were associated with an elevated risk of gout independent of the estimated GFR.

CONCLUSION

Chronic kidney disease manifesting as reduced glomerular function or as presence of blood or protein in the urine increases the risk of incident gout.

Authors+Show Affiliations

Stanford University School of Medicine, Stanford, California.

Pub Type(s)

Journal Article
Observational Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23982888

Citation

Krishnan, Eswar. "Chronic Kidney Disease and the Risk of Incident Gout Among Middle-aged Men: a Seven-year Prospective Observational Study." Arthritis and Rheumatism, vol. 65, no. 12, 2013, pp. 3271-8.
Krishnan E. Chronic kidney disease and the risk of incident gout among middle-aged men: a seven-year prospective observational study. Arthritis Rheum. 2013;65(12):3271-8.
Krishnan, E. (2013). Chronic kidney disease and the risk of incident gout among middle-aged men: a seven-year prospective observational study. Arthritis and Rheumatism, 65(12), 3271-8. https://doi.org/10.1002/art.38171
Krishnan E. Chronic Kidney Disease and the Risk of Incident Gout Among Middle-aged Men: a Seven-year Prospective Observational Study. Arthritis Rheum. 2013;65(12):3271-8. PubMed PMID: 23982888.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic kidney disease and the risk of incident gout among middle-aged men: a seven-year prospective observational study. A1 - Krishnan,Eswar, PY - 2012/09/29/received PY - 2013/08/20/accepted PY - 2013/8/29/entrez PY - 2013/8/29/pubmed PY - 2014/1/28/medline SP - 3271 EP - 8 JF - Arthritis and rheumatism JO - Arthritis Rheum VL - 65 IS - 12 N2 - OBJECTIVE: The kidney is the major organ that facilitates excretion of urate in humans. Surprisingly, few studies have assessed whether a reduced glomerular filtration rate (GFR) and/or kidney damage is associated with a higher incidence of gout, and this study was undertaken to address this question. METHODS: Data from a 7-year followup of patients enrolled in the Multiple Risk Factor Intervention Trial, a primary prevention trial for cardiovascular disease among 12,866 men ages 35-57 years, were used for the present investigation. Presence of gout was determined by the study physicians from the original trial. Chronic kidney disease was defined using criteria similar to those proposed by the National Kidney Foundation. The Cox proportional hazards regression model was used to assess the association between gout and chronic kidney disease, after accounting for the effects of potential confounders. RESULTS: Overall, there were 722 cases of physician- diagnosed incident gout over 76,602 person-years of followup. The standardized incidence ratio of gout among those with chronic kidney disease was 1,217 (95% confidence interval [95% CI] 1,191-1,244). The adjusted hazard ratio (HR) among those with chronic kidney disease was 1.61 (95% CI 1.60-1.61). Each standard deviation decline in the estimated GFR was associated with an HR of 1.43 (95% CI 1.35-1.51). Including the serum urate level, as well as the urate-chronic kidney disease interaction term, as variables in the second analysis did not attenuate the HR. Proteinuria and hematuria, two markers of kidney damage, were associated with an elevated risk of gout independent of the estimated GFR. CONCLUSION: Chronic kidney disease manifesting as reduced glomerular function or as presence of blood or protein in the urine increases the risk of incident gout. SN - 1529-0131 UR - https://www.unboundmedicine.com/medline/citation/23982888/Chronic_kidney_disease_and_the_risk_of_incident_gout_among_middle_aged_men:_a_seven_year_prospective_observational_study_ L2 - https://doi.org/10.1002/art.38171 DB - PRIME DP - Unbound Medicine ER -