From the Research
Chronic kidney disease (CKD) has the highest age- and sex-adjusted odds ratio in people with gout. This is based on the most recent and highest quality study available, which found that patients with gout are approximately 3-4 times more likely to have CKD compared to those without gout 1. The strong association between gout and CKD exists because both conditions share pathophysiological mechanisms, including hyperuricemia, which can directly damage the kidneys through crystal deposition, inflammation, and oxidative stress. Additionally, reduced kidney function impairs uric acid excretion, creating a harmful cycle where kidney disease worsens hyperuricemia, which further damages the kidneys.
Key Points
- CKD is a common comorbidity in patients with gout, with a prevalence of approximately 10-40% 2, 3, 4
- The association between CKD and gout is strong, with patients with gout being 3-4 times more likely to have CKD compared to those without gout 1
- Other significant comorbidities associated with gout include hypertension, diabetes, obesity, and cardiovascular disease, but none have as strong a statistical association as CKD 5, 1
- Monitoring kidney function in gout patients and considering renal impairment when selecting appropriate treatments for gout is crucial, as many medications used for gout management require dose adjustments in patients with kidney disease 2, 4
Comorbidities and Gout
The most common comorbidities in patients with gout include:
- Hypertension (25.4%) 1
- Coronary artery disease (10.3%) 1
- Chronic kidney disease (10.1%) 1
- Hyperlipidemia (8.7%) 1
- Nephrolithiasis (29.4%) 1
- Hydronephrosis (3.2%) 1
- Gallstones (11.9%) 1
Treatment and Management
Treatment of gout in patients with CKD requires careful consideration of renal function and dose adjustments of medications such as allopurinol and febuxostat 2, 4. Urate-lowering therapies (ULT) are effective in controlling elevated uric acid levels, but the percentage of patients treated with ULT increases with advancing stage of CKD 3.