title: Association of kidney disease with prevalent gout in the United States in 1988-1994 and 2007-2010.
abstract: OBJECTIVE
  To determine the prevalence of gout associated with progressive degrees of kidney disease in the US population.
  
  
  METHODS
  We performed a cross-sectional analysis among non-institutionalized adults (age 20 and older) of the National Health and Nutrition Examination Surveys in 1988-1994 and 2007-2010. Gout status was ascertained by self-report of physician-diagnosed gout. Chronic kidney disease (CKD) was defined in stages based on estimated glomerular filtration rate (GFR) and single albuminuria measurements (albumin-to-creatinine ratio). Prevalence ratios comparing successive categories of GFR, albuminuria, and CKD as well as temporal trends over a 22-year interval were determined via Poisson regression.
  
  
  RESULTS
  In the US, the crude prevalence of gout was 2-3% among participants without CKD, 4% among participants with CKD stage 1, 6-10% for stage 2, 11-13% for stage 3, and over 30% for stage 4. The adjusted prevalence ratio comparing the CKD stage 4 stratum to participants without CKD was 3.20 (95% CI: 1.96, 5.24) in 2007-2010 and remained significant even after adjustment for serum uric acid. Notably, there was a statistically significant, progressively greater adjusted prevalence ratio of gout associated with successively lower categories of GFR and higher categories of albuminuria.
  
  
  CONCLUSIONS
  Among US adults, there exists a strong dose-response association between impaired renal function and prevalent gout. Health providers should be aware of the elevated burden of gout among patients with CKD especially when evaluating new onset joint pain and swelling.
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Stephen P
authors: SP
authors: Juraschek
authors: Lara C
authors: LC
authors: Kovell
authors: Edgar R
authors: ER
authors: Miller
authors: Allan C
authors: AC
authors: Gelber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006073:Gout / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D014481:United States / Q000453:epidemiology