Background/Purpose: Patients undergoing kidney transplantation are at increased risk for developing hyperuricemia and gout compared to the general population (generally attributed to the frequent use of calcineurin inhibitors, cyclosporine and tacrolimus). However, the proportion of renal transplant patients that develop gout and the timing in which this occurs post-transplant is less established. This study sought to describe and quantify the incidence of gout in gout-naïve patients undergoing renal transplantation.

Methods: This retrospective analysis of Humana Research Database 2007-2017 claims data (private insurance and Medicare) was performed by identifying kidney transplant patients who were in plan for at least 6 months before and 5 years after transplant. Only patients without an ICD-9/10 gout diagnostic code within 6-months prior to transplant were included. Included patients were then examined for cumulative incidence of gout post-transplant.

Results: The database contained 16,454 patients that underwent kidney transplant. Of these, 920 patients underwent renal transplant, were in plan for at least 6 months before and 5 years after transplant, and did not have a gout diagnostic code before transplant. Of these, 212 patients (23%) had a post-transplant gout code while in plan, and 175 (19%) developed gout within 5 years post-transplant. The proportion of patients with gout progressively increased over time post-transplant and did not plateau. (Figure 1)

Conclusion: Gout is a known frequent comorbidity in solid organ transplant patients, but the timing and proportion of transplant patients who develop gout is not well described. Using a large database analysis, this analysis showed that the proportion of gout-naïve patients undergoing kidney transplantation who develop gout is high and that this proportion only increases as patients are followed over a longer period of time.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/incident-gout-after-renal-transplantation-in-gout-naive-patients-large-database-analysis/