Risk of chronic kidney disease in patients with gout and the impact of urate lowering therapy: a population-based cohort study
Autor: | Alyshah Abdul Sultan, Sara Muller, John Belcher, Matthew Roughley, Rebecca Whittle, Edward Roddy, Christian D Mallen, Lorna Clarson |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty congenital hereditary and neonatal diseases and abnormalities lcsh:Diseases of the musculoskeletal system Gout urologic and male genital diseases Gout Suppressants Cohort Studies RC902 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Chronic kidney disease Humans Medicine 030212 general & internal medicine Renal Insufficiency Chronic Risk factor Urate-lowering therapy Aged Retrospective Studies 030203 arthritis & rheumatology business.industry Proportional hazards model Hazard ratio Cohort nutritional and metabolic diseases Retrospective cohort study Middle Aged medicine.disease Rheumatology Uric Acid Population Surveillance Female lcsh:RC925-935 business Research Article Kidney disease |
Zdroj: | Arthritis Research & Therapy, Vol 20, Iss 1, Pp 1-10 (2018) Arthritis Research & Therapy |
ISSN: | 1478-6362 1478-6354 |
Popis: | Background An association between gout and renal disease is well-recognised but few studies have examined whether gout is a risk factor for subsequent chronic kidney disease (CKD). Additionally, the impact of urate-lowering therapy (ULT) on development of CKD in gout is unclear. The objective of this study was to quantify the risk of CKD stage ≥ 3 in people with gout and the impact of ULT. Methods This was a retrospective cohort study using data from the Clinical Practice Research Datalink (CPRD). Patients with incident gout were identified from general practice medical records between 1998 and 2016 and randomly matched 1:1 to patients without a diagnosis of gout based on age, gender, available follow-up time and practice. Primary outcome was development of CKD stage ≥ 3 based on estimated glomerular filtration rate (eGFR) or recorded diagnosis. Absolute rates (ARs) and adjusted hazard ratios (HRs) were calculated using Cox regression models. Risk of developing CKD was assessed among those prescribed ULT within 1 and 3 years of gout diagnosis. Results Patients with incident gout (n = 41,446) were matched to patients without gout. Development of CKD stage ≥ 3 was greater in the exposed group than in the unexposed group (AR 28.6 versus 15.8 per 10,000 person-years). Gout was associated with an increased risk of incident CKD (adjusted HR 1.78 95% CI 1.70 to 1.85). Those exposed to ULT had a greater risk of incident CKD, but following adjustment this was attenuated to non-significance in all analyses (except on 3-year analysis of women (adjusted HR 1.31 95% CI 1.09 to 1.59)). Conclusions This study has demonstrated gout to be a risk factor for incident CKD stage ≥ 3. Further research examining the mechanisms by which gout may increase risk of CKD and whether optimal use of ULT can reduce the risk or progression of CKD in gout is suggested. Electronic supplementary material The online version of this article (10.1186/s13075-018-1746-1) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
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