Background/Purpose:

Gout affects more than 4% of adults in the United States, and it is the most common form of inflammatory arthritis among men. Studies show that excessive intake of alcoholic beverages, red meat, soft drinks and fruit juices increase the risk of developing gout. Similarly, dairy products and coffee seem to have a protective effect, as they increase the excretion of uric acid. Water is one of the best universal solvents and may be a readily available remedy for gout. As described in previous papers, water helps in the excretion of excess uric acid from the body and will replenish the dehydrated patient but no causal association has been established. Our objective of the study is to look at the association between water intake and uric acid levels in gout patients

Methods:

17,321 individuals from the general population were surveyed by the National Health and Nutrition Examination Survey (NHANES) between 2009-2014. From this data set, 539 participants with a gout diagnosis were selected for the current study after excluding all patients with chronic kidney disease.. Our primary definition of hyperuricemia was a serum uric acid level of ≥6.0 mg/dL. While participants with <6.0 mg/dL uric acid were labeled as normal or low Serum uric acid level. Water intake was considered high for men taking ≥ 3000mg and for women taking ≥ 2200mg; while intake was considered low for men taking < 3000mg and for women taking < 2200mg. Statistical modeling adjusted for demographic characteristics, body mass index, alcohol use, hypertension, diabetes mellitus, and other factors. All analyses were performed with use of SAS version 9.4’s (Cary, North Carolina) Proc survey methodology.

Results:

Thirty nine percent of participants had a uric acid level <6mg/dL, the remainder had uric acid ≥6.0 mg/dL The high uric acid group had significantly more obesity and hypertension, as well as having a significantly higher proportion of males. Multivariate logistic regression showed a significant association between low water intake and hyperuricemia. The odds of developing hyperuricemia was 58% less with high water intake (OR = 0.421, 95% CI: 0.262-0.679, p-value = 0.0007) after adjusting for age, sex, race diabetes, BMI, and hypertension.

Table 1. Multivariate Logistic Regression Analysis for Uric Acid (≥ 6 mg/dL vs. <6 mg/dL)

Conclusion:

In summary, there is a strong association between low water consumption and hyperuricemia. These findings support the physiology of increased uric acid excretion with excess water intake. High water intake may allow for significant benefits to those suffering from gout and warrants further study as a therapeutic intervention.

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/hydration-and-gout-looking-at-new-modes-of-uric-acid-management/