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Open Access Highly Accessed Research article

Risk of end-stage renal disease associated with gout: a nationwide population study

Kuang-Hui Yu12, Chang-Fu Kuo13*, Shue-Fen Luo12, Lai-Chu See45, I-Jun Chou6, Hsiao-Chun Chang1 and Meng-Jiun Chiou45

Author affiliations

1 Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kuei Shan, Taoyuan, 333, Taiwan

2 Department of Internal Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Tao-Yuan, 333, Taiwan

3 Division of Academic Rheumatology, School of Clinical Sciences, University of Nottingham, Nottingham, UK (Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK

4 Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Tao-Yuan, 333, Taiwan

5 Biostatistics Consulting Center, Department of Public Health, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Tao-Yuan, 333, Taiwan

6 Department of Pediatrics, Chang Gung Children's Hospital, 5, Fu-Hsing Street, Kuei Shan, Taoyuan, 333, Taiwan

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Citation and License

Arthritis Research & Therapy 2012, 14:R83  doi:10.1186/ar3806

Published: 18 April 2012

Abstract

Introduction

We explored the risk of end-stage renal disease (ESRD) among gout patients in a representative cohort in Taiwan.

Methods

The primary database used was the Taiwan National Health Insurance Research Database. Subjects older than 20 years without ESRD, coronary heart disease, or stroke were included in the study. The case definition of gout in the present study was gout diagnosis and medical treatment for gout. An ESRD case was defined by the presence of chronic renal failure necessitating long-term renal replacement therapy. Multivariate Cox proportional hazards models were used to evaluate the risk of ESRD among gout patients.

Results

The analysis included data of 656,108 patients who were followed up for a mean of 8.0 years. Among them, 19,963 (3.0%) patients had gout. At the end of 2008, 2,377 individuals (gout, n = 276; non-gout, n = 2,101) had ESRD, and 861 individuals (gout, n = 77, 27.9%; non-gout, n = 521, 24.8%) died due to ESRD. The rates of incidence of ESRD were 1.73 and 0.41 cases per 1,000 patient-years in the gout and non-gout groups. After adjustment for age, sex, and history of diabetes mellitus and/or hypertension, gout was associated with a hazard ratio (HR) of 1.57 for ESRD (95% confidence interval [CI], 1.38-1.79; P < 0.001). In patients with ESRD, the adjusted HR for death in patients with gout was 0.95 (0.74-1.23, P = 0.71), which was similar to the HR obtained in patients without gout.

Conclusions

Gout is associated with an increased hazard for development of ESRD.