Abstract

We aimed to compare clinical characteristics of patients with and without tophi at the time of the diagnosis of gout and investigate the association of tophi and renal function in gout patients. The patients who were first diagnosed with gout at the Kangwon National University Hospital were retrospectively studied. Patients were divided into 2 groups according to the presence of tophi at the diagnosis. We compared clinical characteristics and the progression of renal dysfunction between the two groups. Of 276 patients, 66 (25.5%) initially presented with tophi. Tophi group was older, had a longer symptom duration, and a higher prevalence of multiple joint involvement than those without tophi. In multivariate logistic regression analysis, prolonged symptom duration and multiple joint involvement were significantly associated with increased risk of formation of tophi. The decline in the eGFR was more prominent in patients with tophi than in those without (− 4.8 ± 14.5 vs. − 0.7 ± 11.9 ml/min/1.73 m2/year, respectively; P = 0.039). The presence of tophi was significantly associated with a rapid decline in the eGFR (β = − 0.136; P = 0.042). In conclusion, the presence of tophi was associated with a rapid declining renal function. Therefore, an early diagnosis and closely monitoring of renal function might be important in gout patients with tophi.

Highlights

  • We aimed to compare clinical characteristics of patients with and without tophi at the time of the diagnosis of gout and investigate the association of tophi and renal function in gout patients

  • The 2 groups did not differ with respect to factors such as a history of renal stones, the family history, number of gout flares (≥ 3 per year), concomitant medication, type of urate lowering therapy (ULT), presence of comorbidities (HTN, diabetes mellitus (DM), cardiovascular diseases (CVD), heart failure (HF), dyslipidemia, hypertriglyceridemia, chronic kidney disease [CKD], dementia, and past history of cancer)

  • This study demonstrated that a prolonged duration of symptoms and a high number of involved joints were significantly associated with the presence of tophi at the time of diagnosis in gout patients

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Summary

Introduction

We aimed to compare clinical characteristics of patients with and without tophi at the time of the diagnosis of gout and investigate the association of tophi and renal function in gout patients. Tophi is primarily formed due to an inflammatory response to MSU crystals in which inflammatory cells infiltrate the MSU crystals around the joints This usually occur in longstanding, undiagnosed, or improperly controlled cases of gout, though in rare cases, they may present as an early-stage symptom of ­gout[4,5]. This study aimed to compare the clinical characteristics of patients with and without tophi at the time of diagnosis of gout and investigate the association of tophi and renal function in gout patients . this study aimed to compare the clinical characteristics of patients with and without tophi at the time of diagnosis of gout and investigate the association of tophi and renal function in gout patients

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