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Prevalence and treatment of gout among patients with chronic kidney disease in the Irish health system: a national study

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dc.contributor.author Mohammed, Elshaeima
dc.contributor.author Browne, Leonard D.
dc.contributor.author Kumar A. U., Arun
dc.contributor.author Adeeb, Fahd
dc.contributor.author Fraser, Alexander D.
dc.contributor.author Stack, Austin G.
dc.date.accessioned 2019-02-13T12:01:55Z
dc.date.available 2019-02-13T12:01:55Z
dc.date.issued 2019
dc.identifier.uri http://hdl.handle.net/10344/7587
dc.description peer-reviewed en_US
dc.description.abstract Gout is a common inflammatory arthritis associated with adverse clinical outcomes. Under treatment is common in the general population. The aim of this study was to determine the prevalence of gout and its treatment among patients with chronic kidney disease (CKD). Methods We conducted a multi-centre cross sectional study of patients (n = 522) who attended specialist nephrology clinics in Ireland. Standardized data collection tool recorded clinical characteristics and medication use at clinic visits and kidney function was assessed with standardised creatinine measurements and Estimated Glomerular Filtration Rate (eGFR). The prevalence of gout and the corresponding use of urate lowering therapies (ULT) were determined. Multivariate logistic regression explored correlates of gout expressed as Odds Ratios (OR) and 95% Confidence Intervals (CI) adjusting for demographic and clinical characteristics. Results Overall prevalence of gout was 16.6% and increased significantly from 7.5% in Stage 1–2 CKD to 22.8% in stage 4–5 CKD, P< 0.005. Prevalence increased with age (P < 0.005) and was higher in men than women (19.1% versus 10.3% P< 0.005). Overall, 67.9% of gout patients with CKD were treated with ULT, and the percentage increased with advancing stage of CKD from 55.6% in Stage 1–2 to 77.4% in Stage 4–5, P<0.005. Multivariable modelling identified men (vs women), OR, 1.95 (0.95–4.03), serum albumin, OR 1.09 (1.02–1.16) per 1 g/L lower, poorer kidney function, OR 1.11 (1.01–1.22) per 5 ml/min/ 1.73m2 lower, and rising parathyroid hormone levels, OR 1.38 (1.08–1.77) per 50 pg/ml higher as disease correlates. Conclusions Gout is common in CKD and increases with worsening kidney function in the Irish health system. Over two thirds of patients with gout were receiving ULT, increasing to 77% of patients with advanced CKD. Greater awareness of gout in CKD, its treatment and the effectiveness of treatment strategies should be vigorously monitored to improve patient outcomes. en_US
dc.language.iso eng en_US
dc.publisher Public Library of Science en_US
dc.relation.ispartofseries PLoS ONE;14(1): e0210487
dc.relation.uri https://doi.org/10.1371/journal.pone.0210487
dc.subject gout en_US
dc.subject inflammatory arthritis en_US
dc.title Prevalence and treatment of gout among patients with chronic kidney disease in the Irish health system: a national study en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1371/journal.pone.0210487
dc.contributor.sponsor Irish Heart Foundation en_US
dc.contributor.sponsor Midwest Kidney Disease Research and Education Foundation (MKid) en_US
dc.contributor.sponsor HRB en_US
dc.relation.projectid HRA-2013-PHR-685 and HRA-2013-PHR-437 en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 2870545


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