Abstract
IntroductionTo determine the prevalence of chronic kidney disease and nephrolithiasis in people with gout, and the association between gout and prevalent or incident chronic kidney disease and nephrolithiasis.MethodsSystematic review and meta-analysis of epidemiological studies. Data sources; MEDLINE, EMBASE and CINAHL databases, hand-searched reference lists, citation history and contact with authors. Eligibility criteria: cohort, case–control or cross-sectional studies which examined the occurrence of chronic kidney disease or nephrolithiasis amongst adults with gout (with or without a non-gout comparator group) in primary care or general population samples. Prevalence and risk estimate meta-analyses were performed using a random-effects model.ResultsSeventeen studies were included in the meta-analysis (chronic kidney disease n = 7, nephrolithiasis n = 8, both n = 2). Pooled prevalence estimates of chronic kidney disease stage ≥3 and self-reported lifetime nephrolithiasis in people with gout were 24% (95% confidence interval 19% to 28%) and 14% (95% CI 12% to 17%) respectively. Gout was associated with both chronic kidney disease (pooled adjusted odds ratio 2.41, 95% confidence interval 1.86 to 3.11) and self-reported lifetime nephrolithiasis (1.77, 1.43 to 2.19).ConclusionsChronic kidney disease and nephrolithiasis are commonly found amongst patients with gout. Gout is independently associated with both chronic kidney disease and nephrolithiasis. Patients with gout should be actively screened for chronic kidney disease and its consequences.
Highlights
To determine the prevalence of chronic kidney disease and nephrolithiasis in people with gout, and the association between gout and prevalent or incident chronic kidney disease and nephrolithiasis
Our findings demonstrate a clear independent association between gout and both Chronic kidney disease (CKD) and nephrolithiasis, there were few prospective studies so we could not draw firm conclusions about temporal aspects of these associations
The main clinical implications of our findings are that patients with gout should be screened for CKD and that clinicians should be made aware of the associations between gout and CKD/nephrolithiasis
Summary
To determine the prevalence of chronic kidney disease and nephrolithiasis in people with gout, and the association between gout and prevalent or incident chronic kidney disease and nephrolithiasis. Gout is the most prevalent inflammatory arthritis, affecting 2.4% of adults in the UK [1]. Gout is associated with considerable co-morbidity including hypertension, diabetes mellitus, obesity, metabolic syndrome, and vascular disease [2]. Associations between gout and renal disease and nephrolithiasis have long been recognised, yet early studies undertaken in specialist secondary care populations are likely to be unrepresentative of most patients with gout who are managed exclusively in primary care settings [3,4,5,6]. Chronic kidney disease (CKD) stages 3 to 5 (glomerular filtration rate
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