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06 November 2018
In an observational study in the United Kingdom, stage 3 or higher chronic renal failure was 78% more likely to develop in patients with pseudo-gout during a median follow-up of 6 years.
Gout is a risk factor for development. British researchers concluded that stage 3 of chronic kidney disease (CKD) or more was superior.
In a retrospective cohort study comparing 41,446 new cases of gout to an equal number of patients without gout, Matthew J. Roughley, MBChB, of East London. NHS Foundation Trust and colleagues found that stage 3 or more of CKD had appeared in 6694 patients with gout (16.2%) and 3953 patients without gout (9.5%) during the course of the study. a median follow-up period of 6 years.
The absolute rate of CKD stage 3 or higher (per 10,000 person-years) was 28.6 in the gout group, compared to 15.8 in the no-gout group, according to the findings published in Arthritis Research & Therapy . After adjusting for age, bad, comorbidities, and other variables, gout was badociated with a significant 78% increase in the risk of stage 3 or higher chronic nephropathy.
Adjusted badyzes did not have a significant effect on the development of chronic nephropathy by means of cholesterol-lowering therapy.
Researchers determined stage 3 or higher development of chronic kidney disease based on two consecutive measurements of a glomerular filtration rate estimated to be less than 60 ml / day. min / 1.73 m 2 at least 3 months apart
Originally, the patients had a mean age of 57 years and 81% were men. Compared to the no-gout group, gout patients had a higher prevalence of diabetes mellitus (6.5% vs. 5.8%), treated hypertension (28.9% vs. 16%), and diabetes mellitus. obesity (36.9% vs. 20.3%).
"Although it is not possible to draw conclusions of causality from this observational study," said Dr. Roughley's team, "it is useful to" examine potential plausible mechanisms for the badociation between gout and CKD. Kidney damage could result from comorbid hypertension, diabetes mellitus, obesity or the use of nonsteroidal anti-inflammatory drugs. "
Regarding the strengths of the study, the investigators noted that patients had been selected from primary care settings where most patients with gout were managed, which would help generalizability. "The size of the sample was large and the median follow-up was 6 years, which should be sufficient for the development and determination of the stage of chronic nephropathy ≥3."
The authors acknowledged that verification bias was a possible limitation of the study, since patients with gout exhibited more frequently in general practitioners and hospitals and had a higher prevalence of hypertension and diabetes, "which could have prompted further testing of renal function. "
Reference
Roughley M, Sultan AA, Clarson L, et al. chronic in patients with gout and impact of anti-hypoglycemic treatment: a cohort study in population. Arthritis Res Ther. 2018; 20: 243. doi: 10.1186 / s13075-018-1746-1
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