Risk of end-stage renal disease associated with gout: a nationwide population study

The primary database used was the Taiwan National Health Insurance Research Database. Subjects older than 20 years without ESRD, coronary heart disease, or stroke were included in the study. The case definition of gout in the present study was gout diagnosis and medical treatment for gout. An ESRD case was defined by the presence of chronic renal failure necessitating long-term renal replacement therapy. Multivariate Cox proportional hazards models were used to evaluate the risk of ESRD among gout patients.The analysis included data of 656,108 patients who were followed up for a mean of 8.0 years. Among them, 19,963 (3.0%) patients had gout. At the end of 2008, 2,377 individuals (gout, n = 276; non-gout, n = 2,101) had ESRD, and 861 individuals (gout, n = 77, 27.9%; non-gout, n = 521, 24.8%) died due to ESRD. The rates of incidence of ESRD were 1.73 and 0.41 cases per 1,000 patient-years in the gout and non-gout groups. After adjustment for age, sex, and history of diabetes mellitus and/or hypertension, gout was associated with a hazard ratio (HR) of 1.57 for ESRD (95% confidence interval [CI], 1.38-1.79; P < 0.001). In patients with ESRD, the adjusted HR for death in patients with gout was 0.95 (0.74-1.23, P = 0.71), which was similar to the HR obtained in patients without gout.Gout is associated with an increased hazard for development of ESRD.Chronic kidney disease (CKD) is the progressive loss of renal function over a period of months or years. Continuous deterioration of renal function in patients with CKD eventually leads to the development of end-stage renal disease (ESRD). Patients with ESRD require renal replacement therapy, such as hemodialysis, peritoneal dialysis, or kidney transplantation, for sustenance. ESRD is increasingly becoming a major health burden worldwide [1,2]. The prevalence and incidence of ESRD are alarmingly high in Taiwan in particular [3]. A recent study based on data from the National Dialysis Registry of Taiwan revealed that 48,072 p