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Abstract: PO0800

Characterization of Gout in US Patients Treated with Hemodialysis (HD) and Peritoneal Dialysis (PD)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Karaboyas, Angelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Zhao, Junhui, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • LaMoreaux, Brian, Horizon Therapeutics plc, Novato, California, United States
  • Marder, Brad, Horizon Therapeutics plc, Novato, California, United States
  • Gorlitsky, Barry R., Carolina Nephrology PA, Greenville, South Carolina, United States
  • Domingues, Vinicius, Florida State University College of Medicine, Tallahassee, Florida, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background

Gout occurs frequently in patients with renal disease and can lead to a significant burden on quality of life and functional status. In the US hemodialysis (HD) and peritoneal dialysis (PD) population, there has been little reported on gout prevalence, patient characteristics, and associations with outcomes.

Methods

We used data from US cohorts of 70,297 HD (DOPPS, 2012-2020) patients and 5,117 PD (PDOPPS, 2014-2020) patients. We took a stepwise approach to define gout based on active prescription of (1) colchicine, (2) febuxostat, or (3) allopurinol; or (4) prior diagnosis of gout. Propensity score matching was used to compare outcomes – including erythropoietin resistance index (ERI = ESA dose/(hemoglobin*weight)), mortality and hospitalization, and baseline patient-reported outcomes (PROs) – among patients with vs. without a history of gout.

Results

Gout prevalence was 13% in HD and 21% in PD, and was highest among incident dialysis patients. Contributions of colchicine Rx (2-3%) and febuxostat Rx (1%) were lower than allopurinol Rx (9-12%), and additional contribution of gout diagnosis was minimal [Figure 1]. Both HD and PD patients with gout (vs. no gout) were older, more likely male, with higher BMI, and higher prevalence of cardiovascular comorbidities. After propensity score matching, mean ERI was 4% higher for gout vs. non-gout patients, while there was minimal evidence of association with clinical outcomes or PROs.

Conclusion

Gout was common in US HD and PD patients, with a large proportion of these patients treated with drugs indicated for hyperuricemia (allopurinol and febuxostat) and gout flares (colchicine). True prevalence was likely higher than observed when considering under-ascertainment of gout diagnosis history. This report provides a snapshot of gout in the US dialysis population and offers opportunities to expand on research to improve awareness and care for patients with gout and ESRD.

Funding

  • NIDDK Support