Prevalence and correlates of gout in a large cohort of patients with chronic kidney disease: the German Chronic Kidney Disease (GCKD) study

被引:81
作者
Jing, Jiaojiao [1 ]
Kielstein, Jan T. [2 ]
Schultheiss, Ulla T. [1 ]
Sitter, Thomas [3 ]
Titze, Stephanie I. [4 ]
Schaeffner, Elke S. [5 ]
McAdams-DeMarco, Mara [6 ]
Kronenberg, Florian [7 ]
Eckardt, Kai-Uwe [4 ]
Koettgen, Anna [1 ]
机构
[1] Univ Freiburg, Med Ctr, Div Renal, Freiburg, Germany
[2] Hannover Med Sch, Dept Hypertens & Nephrol, Hannover, Germany
[3] Ludwig Maximilians Univ Hosp, Dept Med, Munich, Germany
[4] Univ Erlangen Nurnberg, Dept Hypertens & Nephrol, D-91054 Erlangen, Germany
[5] Charite, Div Nephrol & Intens Care Med, D-13353 Berlin, Germany
[6] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[7] Med Univ Innsbruck, Div Genet Epidemiol, A-6020 Innsbruck, Austria
关键词
chronic kidney disease; correlates; estimated glomerular filtration rate; GCKD study; gout epidemiology; observational study; ACID-LOWERING THERAPY; URIC-ACID; INCIDENT GOUT; ATHEROSCLEROSIS RISK; FOLLOW-UP; HYPERURICEMIA; POPULATION; EPIDEMIOLOGY; MEN; HYPERTENSION;
D O I
10.1093/ndt/gfu352
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Reduced kidney function is a risk factor for hyperuricaemia and gout, but limited information on the burden of gout is available from studies of patients with chronic kidney disease (CKD). We therefore examined the prevalence and correlates of gout in the large prospective observational German Chronic Kidney Disease (GCKD) study. Data from 5085 CKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) of 30-< 60 mL/min/1.73 m(2) or eGFR a parts per thousand yen60 and overt proteinuria at recruitment and non-missing values for self-reported gout, medications and urate measurements from a central laboratory were evaluated. The overall prevalence of gout was 24.3%, and increased from 16.0% in those with eGFR a parts per thousand yen60 mL/min/1.73 m(2) to 35.6% in those with eGFR < 30. Of those with self-reported gout, 30.7% of individuals were not currently taking any gout medication and among gout patients on urate lowering therapy, 47.2% still showed hyperuricaemia. Factors associated with gout were serum urate, lower eGFR, advanced age, male sex, higher body mass index and waist-to-hip ratio, higher triglyceride and C-reactive protein (CRP) concentrations, alcohol intake and diuretics use. While lower eGFR categories showed significant associations with gout in multivariable-adjusted models (prevalence ratio 1.46 for eGFR < 30 compared with eGFR a parts per thousand yen60, 95% confidence interval 1.21-1.77), associations between gout and higher urinary albumin-to-creatinine ratio in this CKD population were not significant. Self-reported gout is common among patients with CKD and lower GFR is strongly associated with gout. Pharmacological management of gout in patients with CKD is suboptimal. Prospective follow-up will show whether gout and hyperuricaemia increase the risk of CKD progression and cardiovascular events in the GCKD study.
引用
收藏
页码:613 / 621
页数:9
相关论文
共 41 条
[1]   Gout in the UK and Germany: prevalence, comorbidities and management in general practice 2000-2005 [J].
Annemans, L. ;
Spaepen, E. ;
Gaskin, M. ;
Bonnemaire, M. ;
Malier, V. ;
Gilbert, T. ;
Nuki, G. .
ANNALS OF THE RHEUMATIC DISEASES, 2008, 67 (07) :960-966
[2]   Challenges of conducting a trial of uric-acid-lowering therapy in CKD [J].
Badve, Sunil V. ;
Brown, Fiona ;
Hawley, Carmel M. ;
Johnson, David W. ;
Kanellis, John ;
Rangan, Gopala K. ;
Perkovic, Vlado .
NATURE REVIEWS NEPHROLOGY, 2011, 7 (05) :295-300
[3]   Epidemiology of Gout in Women Fifty-two-Year Followup of a Prospective Cohort [J].
Bhole, Vidula ;
de Vera, Mary ;
Rahman, M. Mushfiqur ;
Krishnan, Eswar ;
Choi, Hyon .
ARTHRITIS AND RHEUMATISM, 2010, 62 (04) :1069-1076
[4]   Effects of uric acid-lowering therapy on renal outcomes: a systematic review and meta-analysis [J].
Bose, Bhadran ;
Badve, Sunil V. ;
Hiremath, Swapnil S. ;
Boudville, Neil ;
Brown, Fiona G. ;
Cass, Alan ;
de Zoysa, Janak R. ;
Fassett, Robert G. ;
Faull, Randall ;
Harris, David C. ;
Hawley, Carmel M. ;
Kanellis, John ;
Palmer, Suetonia C. ;
Perkovic, Vlado ;
Pascoe, Elaine M. ;
Rangan, Gopala K. ;
Walker, Robert J. ;
Walters, Giles ;
Johnson, David W. .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2014, 29 (02) :406-413
[5]   Obesity, weight change, hypertension, diuretic use, and risk of gout in men - The health professionals follow-up study [J].
Choi, HK ;
Atkinson, K ;
Karlson, EW ;
Curhan, G .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (07) :742-748
[6]   Alcohol intake and risk of incident gout in men: a prospective study [J].
Choi, HK ;
Atkinson, K ;
Karlson, EW ;
Willett, W ;
Curhan, G .
LANCET, 2004, 363 (9417) :1277-1281
[7]   Purine-rich foods, dairy and protein intake, and the risk of gout in men [J].
Choi, HK ;
Atkinson, K ;
Karlson, EW ;
Willett, W ;
Curhan, G .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (11) :1093-1103
[8]   Pathogenesis of gout [J].
Choi, HK ;
Mount, DB ;
Reginato, AM .
ANNALS OF INTERNAL MEDICINE, 2005, 143 (07) :499-516
[9]  
Choi HK, 2005, CURR OPIN RHEUMATOL, V17, P341
[10]   Obesity and Younger Age at Gout Onset in a Community-Based Cohort [J].
DeMarco, Mara A. McAdams ;
Maynard, Janet W. ;
Huizinga, Mary Margret ;
Baer, Alan N. ;
Koettgen, Anna ;
Gelber, Allan C. ;
Coresh, Josef .
ARTHRITIS CARE & RESEARCH, 2011, 63 (08) :1108-1114