title: Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies.
abstract: BACKGROUND
  To determine the prevalence of chronic kidney disease and nephrolithiasis in people with gout, and the association between gout and prevalent or incident chronic kidney disease and nephrolithiasis.
  
  
  METHODS
  Systematic review and meta-analysis of epidemiological studies. Data sources; MEDLINE, EMBASE and CINAHL databases, hand-searched reference lists, citation history and contact with authors.
  
  
  METHODS
  cohort, case-control or cross-sectional studies which examined the occurrence of chronic kidney disease or nephrolithiasis amongst adults with gout (with or without a non-gout comparator group) in primary care or general population samples. Prevalence and risk estimate meta-analyses were performed using a random-effects model.
  
  
  RESULTS
  Seventeen studies were included in the meta-analysis (chronic kidney disease n = 7, nephrolithiasis n = 8, both n = 2). Pooled prevalence estimates of chronic kidney disease stage ≥3 and self-reported lifetime nephrolithiasis in people with gout were 24% (95% confidence interval 19% to 28%) and 14% (95% CI 12% to 17%) respectively. Gout was associated with both chronic kidney disease (pooled adjusted odds ratio 2.41, 95% confidence interval 1.86 to 3.11) and self-reported lifetime nephrolithiasis (1.77, 1.43 to 2.19).
  
  
  CONCLUSIONS
  Chronic kidney disease and nephrolithiasis are commonly found amongst patients with gout. Gout is independently associated with both chronic kidney disease and nephrolithiasis. Patients with gout should be actively screened for chronic kidney disease and its consequences.
authors.affiliation: School of Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK. mattjroughley@gmail.com.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Roughley
authors.affiliation: School of Computing and Mathematics, Keele University, Keele, Staffordshire, ST5 5BG, UK. j.belcher@keele.ac.uk.
authors.forename: John
authors.initials: J
authors.lastname: Belcher
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK. c.d.mallen@keele.ac.uk.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Mallen
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK. e.roddy@keele.ac.uk.
authors.forename: Edward
authors.initials: E
authors.lastname: Roddy
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006073:Gout / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D064887:Observational Studies as Topic; D015995:Prevalence; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D018570:Risk Assessment