PT  - JOURNAL ARTICLE
AU  - Weiqi Wang
AU  - Vidula Manish Bhole
AU  - Eswar Krishnan
TI  - Chronic kidney disease as a risk factor for incident gout among men and women: retrospective cohort study using data from the Framingham Heart Study
AID  - 10.1136/bmjopen-2014-006843
DP  - 2015 Apr 01
TA  - BMJ Open
PG  - e006843
VI  - 5
IP  - 4
4099  - http://bmjopen.bmj.com/content/5/4/e006843.short
4100  - http://bmjopen.bmj.com/content/5/4/e006843.full
SO  - BMJ Open2015 Apr 01; 5
AB  - Objectives Historically, the nature of association between chronic kidney disease (CKD) and gouty arthritis has been unclear. The goal of the present study was to test the hypothesis that CKD is an independent risk factor for developing incident gout.Design Patients were from the original Framingham Heart Study cohort. Using Cox proportional hazard models we estimated the HR of CKD to incident gout among men and women separately after adjusting for age, alcohol consumption, smoking, hypertension, diabetes and body mass index.Settings Patients were all from Framingham, Massachusetts, USA.Participants Excluding patients who had CKD in the first visit from this study, 2159 men and 2558 women were selected covering a 54-year period (1948–2002).Results There were 371 incident cases (231 men and 140 women) of gout over the follow-up of 140 421 person-years. Incidence rates of gout per 1000 person-years for participants with and without CKD were 6.82 (95% CI 5.10 to 9.10) and 2.43 (2.18 to 2.71), respectively. In multivariable Cox models, CKD was associated with gout, with a HR of 1.88 (1.13 to 3.13) among men and 2.31 (1.25 to 4.24) among women. Additional analyses using alternate definitions for CKD and cross-sectional study did not change the results. Sensitivity analysis suggested that the observed findings might be an underestimate of the true relative risk.Conclusions The present study provides epidemiological evidence to support the notion that CKD is a risk factor for gout.