Background/Purpose: Graft-related complications are among the most serious issues solid-organ transplant recipients and their healthcare teams face post-operatively. Gout is a known frequent co-morbidity in transplant patients. Whether renal transplant patients with gout suffer from higher rates of transplant-related complications, as compared to transplant patients without gout, has not been investigated. We analyzed a large US population database to determine the overall transplant complication rate in patients having a renal transplant with and without gout.

Methods: A retrospective review of Humana Research Database claims data (2007-2017) was undertaken to identify kidney transplant patients with ≥6 months in plan before and after transplant. Diagnostic gout codes (ICD 9/10) were used to categorize patients into gout and non-gout groups. Additionally patients were classified as having gout pre- or post-transplant based on when the first gout code occurred. Transplant complications were determined using the ICD 9 code for complications of transplanted kidney and ICD 10 codes for unspecified and other complications of kidney transplant, kidney transplant rejection, failure, and infection.

Results: The database contained 6085 patients with a kidney transplant and ≥6 months in plan both pre and post-transplant. Of these, 1504 patients had ≥1 gout codes (the first code occurred in 909 patients pre-transplant and 595 post-transplant), and 4581 patients never had a gout code. The renal transplant complication rate in the overall cohort was 36.0%. Patients with gout had a higher complication rate (40.4%) than those without gout (34.6%, OR: 1.28, 95% CI: 1.136–1.443, p< 0.001). The higher complication rate in gout patients was driven by those who developed gout post-transplant.(Table 1)

Conclusion: Our analysis indicates that patients with gout, especially those with gout arising post-transplant, suffered from higher rates of overall transplant-related complications. In addition to more research on this topic, an increased focus on awareness and screening of renal transplant patients for gout is warranted.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/renal-transplant-complications-in-patients-with-and-without-gout/