Advanced age, a previous kidney transplant and comorbid hypertension are significantly associated with an increased risk of gout in patients on dialysis, according to the results of a study presented at Kidney Week 2021 of the American Society of Nephrology.
The study also found that dialysis patients with gout have higher requirements for erythropoiesis-stimulating agents (ESAs), higher ferritin levels, and lower transferrin saturation, “implying the impact. of gout on erythropoiesis, possibly due to chronic systemic inflammation, âAnthony J. Bleyer, MD, of the Wake Forest School of Medicine in Winston-Salem, NC, and colleagues reported in a poster presentation.
Investigators analyzed data from the US Renal Data System on 275,651 patients on dialysis, of which 41,312 (15%) had gout and 234,339 (85%) did not. Compared to non-gout patients, gout patients were older (mean age 63.5 vs. 56.8 years), male (62% vs. 54%) and obese (mean body mass index 31.4 vs. 30, 2 kg / m2). Patients with gout had a higher incidence of hospitalizations (66.3% vs. 56.9%) and a higher prevalence of cardiovascular disease (CVD), including heart failure (49% vs. 30%), heart disease ischemic (49% vs. 30%), vascular disease (32% vs. 22%, acute myocardial infarction (7% vs. 3%) and angina (4% vs. 2%), reported Dr. Bleyer’s team in a poster presentation.
Compared with patients younger than 65, those 65 or older had a 4.2-fold higher risk of gout, in adjusted analyzes. Patients with previous kidney transplants and those with comorbid hypertension had a significantly increased probability of gout of 2.4 and 2.7 times, respectively.
In adjusted analyzes, gout was significantly associated with a 9% increased risk of death and an 11% increased risk for a composite of CVD hospitalization and death.
“Our study strengthens the evidence for gout as a risk factor for death from cardiovascular and kidney disease,” Dr Bleyer told participants. “An increased awareness of the risk factors for gout in dialysis patients, such as a higher frequency in men and the elderly, as well as the association with co-morbidities such as obesity and cardiovascular disease may aid in the diagnosis of gout and improve clinical outcomes. “
This research was supported by Horizon Therapeutics. Please see the original reference for a full list of disclosures.
Bleyer AJ, Zhang Y, Kshirsagar O, Marder, LaMoreaux B. Risk factors and outcomes for gout in dialysis patients: a United States Renal Data System (USRDS) cohort study. Presented at: Kidney Week 2021, November 2-7, 2021. Poster PO0792.