Kidney Week

Abstract: FR-PO214

Prevalence of CKD, Xanthine Oxidase Inhibitor Treatment, and Serum Uric Acid Control in US Adults with Gout: NHANES 2007–2014

Session Information

• CKD: Clinical, Outcomes, Trials - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Lim, Jean J., Ironwood Pharmaceuticals, Inc., Cambridge, Massachusetts, United States

Jean J. Lim,

• Fu, An-Chen, Ironwood Pharmaceuticals, Inc., Cambridge, Massachusetts, United States

An-Chen Fu,

• Reasner, David S., Ironwood Pharmaceuticals, Inc., Cambridge, Massachusetts, United States

David S. Reasner,

• Taylor, Douglas C.A., Ironwood Pharmaceuticals, Inc., Cambridge, Massachusetts, United States

Douglas C.A. Taylor,

Background

Gout is the most common form of inflammatory arthritis, mainly caused by elevated serum uric acid (sUA). The American College of Rheumatology recommends lowering sUA to <6 mg/dL for gout patients, most commonly achieved by lifestyle changes and xanthine oxidase inhibitor (XOI) treatment. Elevated sUA is also associated with the prevalence of chronic kidney disease (CKD). This study aims to estimate the prevalence of CKD among US adults (age ≥20 years) with gout, stratified by XOI treatment status and sUA control (<6 mg/dL).

Methods

This cross-sectional study was conducted using the National Health and Nutrition Examination Survey (NHANES) 2007–2014 including patients who had ever been told by a doctor that they had gout. CKD was categorized based on 2012 Kidney Disease: Improving Global Outcomes using estimated glomerular filtration rate (eGFR; CKD-EPI equation) and urine albumin-creatinine ratio. Descriptive analyses were performed accounting for the survey’s complex sampling design.

Results

Of 20,880 participants (representing an estimated 207 M US non-institutionalized adults), 899 (representing 7.8 M) had gout. Among the gout population, 4.9 M (63%) had uncontrolled sUA, 2.8 M (36%) had moderate or higher risk of CKD, and 2.2 M (28%) were taking an XOI. Of the gout population who were not taking an XOI, the majority were uncontrolled regardless of CKD risk (Table).

Conclusion

Among gout patients, more than one third have moderate or higher risk of CKD, and less than one third are currently treated with XOI and of those, 43% have uncontrolled sUA. Therefore, gout patients may benefit from sUA-lowering treatment options that are consistent with their renal function.

Funding

• Commercial Support – Ironwood Pharmaceuticals, Inc.