title: Gout after living kidney donation: a matched cohort study.
abstract: BACKGROUND
  In the general population, high serum uric acid concentration is a risk factor for gout. It is unknown whether donating a kidney increases a living donor's risk of gout as serum uric acid concentration increases in donors after nephrectomy.
  
  
  METHODS
  Retrospective matched cohort study using large health care databases.
  
  
  METHODS
  We studied living kidney donors who donated in 1992 to 2010 in Ontario, Canada. Matched nondonors were selected from the healthiest segment of the general population. 1,988 donors and 19,880 matched nondonors were followed up for a median of 8.4 (maximum, 20.8) years.
  
  
  METHODS
  Living kidney donor nephrectomy.
  
  
  RESULTS
  The primary outcome was time to a diagnosis of gout. The secondary outcome in a subpopulation was receipt of medications typically used to treat gout (allopurinol or colchicine).
  
  
  METHODS
  We assessed the primary outcome with health care diagnostic codes.
  
  
  RESULTS
  Donors compared with nondonors were more likely to be given a diagnosis of gout (3.4% vs 2.0%; 3.5 vs 2.1 events/1,000 person-years; HR, 1.6; 95% CI, 1.2-2.1; P<0.001). Similarly, donors compared with nondonors were more likely to receive a prescription for allopurinol or colchicine (3.8% vs 1.3%; OR, 3.2; 95% CI, 1.5-6.7; P=0.002). Results were consistent in multiple additional analyses.
  
  
  CONCLUSIONS
  The primary outcome was assessed using diagnostic codes in health care databases. Laboratory values for serum uric acid and creatinine in follow-up were not available in our data sources.
  
  
  CONCLUSIONS
  The findings suggest that donating a kidney modestly increases an individual's absolute long-term incidence of gout. This unique observation should be corroborated in future studies.
authors.affiliation: Department of Medicine, Division of Nephrology, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
authors.forename: Ngan N
authors.initials: NN
authors.lastname: Lam
authors.affiliation: Institute for Clinical Evaluative Sciences (ICES), Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: McArthur
authors.affiliation: Institute for Clinical Evaluative Sciences (ICES), Ontario, Canada; Department of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: S Joseph
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: G V Ramesh
authors.initials: GV
authors.lastname: Prasad
authors.affiliation: Department of Medicine, Division of Nephrology, Saint Louis University, St Louis, MO; Center for Outcomes Research, Saint Louis University, St Louis, MO.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lentine
authors.affiliation: Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Reese
authors.affiliation: Department of Medicine, Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, MN.
authors.forename: Bertram L
authors.initials: BL
authors.lastname: Kasiske
authors.affiliation: Department of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Charmaine E
authors.initials: CE
authors.lastname: Lok
authors.affiliation: Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Liane S
authors.initials: LS
authors.lastname: Feldman
authors.affiliation: Department of Medicine, Division of Nephrology, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences (ICES), Ontario, Canada. Electronic address: amit.garg@lhsc.on.ca.
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
mesh_terms: D000328:Adult; D000493:Allopurinol / Q000627:therapeutic use; D016022:Case-Control Studies; D015331:Cohort Studies; D003078:Colchicine / Q000627:therapeutic use; D005260:Female; D006073:Gout / Q000188:drug therapy / Q000453:epidemiology*; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006074:Gout Suppressants; D000493:Allopurinol; D003078:Colchicine
keywords: Cohort study; allopurinol; colchicine; diagnostic codes; donor outcomes; gout; health administrative data; health outcomes; hyperuricemia; kidney donation; living kidney donor; nephrectomy; renal transplantation; uric acid