Session Title: Metabolic and Crystal Arthropathies II
Session Type: Abstract Submissions (ACR)
Even though the prevalence of chronic kidney disease (CKD) has been shown to be dispoportionarely high among those with gout, there have been scant data on temporal relationship between the two.
We analyzed data from the Framingham heart study (FHS) spanning 52 years from 1948 to 2000, over 26 study visits. Gout was defined as X-ray identified gout or physician diagnosed gout or usage of any gout medication or self-reported gout or presence of individual gout history. CKD was defined as physician diagnosed CKD or presence of CKD history. Hypertension was defined as systolic blood pressure >= 140 mm Hg or diastolic blood pressure >= 90 mm Hg or usage of anti-hypertensive medications. The alcohol and tobacco usage were self-reported. Diabetes and BMI was defined according to FHS official review. Statistical analyses were performed using Cox proportional hazard regression models, where the dependent variable was the time to incident gout. All covariates that entered the multivariable models (CKD, sex, age, BMI, hypertension, diabetes, usage of alcohol and tobacco) were treated as time varying in the regression models. Missing values were addressed by multiple imputations.
There were 5079 participants that were included, among whom 815 had CKD. At the baseline the proportion of men was 45.17%. Overall there were 414 incident cases of gout during the follow up. The incidence rate per thousand person-years of gout in the CKD group was 4.37 and in the non-CKD group was 2.53. The unadjusted and age adjusted hazard ratio of CKD were 1.48 (95% confidence interval 1.15-1.90) and 1.48 (1.15-1.90) respectively. In multivariable Cox models, CKD was associated with a hazard ratio of 1.68 (1.23-2.29).
CKD is a risk factor for gout, independent of gender, increasing age, obesity, hypertension, diabetes, usage of tobacco and alcohol.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/kidney-disease-is-an-independent-risk-factor-for-incident-gout/