title: Risk of end-stage renal disease associated with gout: a nationwide population study.
abstract: BACKGROUND
  We explored the risk of end-stage renal disease (ESRD) among gout patients in a representative cohort in Taiwan.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Gout is associated with an increased hazard for development of ESRD.
authors.affiliation: Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kuei Shan, Taoyuan, 333, Taiwan.
authors.forename: Kuang-Hui
authors.initials: KH
authors.lastname: Yu
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Kuo
authors.forename: Shue-Fen
authors.initials: SF
authors.lastname: Luo
authors.forename: Lai-Chu
authors.initials: LC
authors.lastname: See
authors.forename: I-Jun
authors.initials: IJ
authors.lastname: Chou
authors.forename: Hsiao-Chun
authors.initials: HC
authors.lastname: Chang
authors.forename: Meng-Jiun
authors.initials: MJ
authors.lastname: Chiou
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006073:Gout / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult