Abstract: FR-PO1026
Risk of Gout Flares During the Transition to Maintenance Dialysis in Patients with Advanced CKD
Session Information
- Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Gaffo, Angelo L., University of Alabama at Birmingham Health System, Birmingham, Alabama, United States
- Zhang, Yi, MTPPI Medical Technology and Practice Patterns Institute, Bethesda, Maryland, United States
- Thamer, Mae, MTPPI Medical Technology and Practice Patterns Institute, Bethesda, Maryland, United States
- Kumar, Vineeta, University of Alabama at Birmingham Health System, Birmingham, Alabama, United States
Background
Gout is common in advanced chronic kidney disease. The transition to end-stage kidney disease (ESKD) and maintenance dialysis induces changes that may affect the risk of gout flares, but temporal patterns during this period are not known.
Methods
Retrospective cohort study using United States Renal Data System (2017–2022) among incident dialysis patients aged ≥67 years with ≥2 gout diagnoses and continuous Medicare Parts A/B coverage during the 2 years before and after ESKD onset. Gout flares were identified using a validated claims-based algorithm incorporating gout flare medications, emergency department or inpatient encounters with a 30-day washout period. A self-controlled case series (SCCS) design compared flare rates during pre-ESKD (−730 to −1 days), transition to ESKD (0–90 days), and post-transition (91–730 days) periods. Conditional Poisson regression estimated incidence rate ratios (IRRs)
Results
Among 5403 patients with ≥1 gout flare (Table), 7690 flares were identified. Crude flare rates (per person-year) were 0.44 pre-ESKD, 0.65 during transition, and 0.35 post-ESKD. (Figure 1) Compared with pre-ESKD, flare risk was higher during transition (IRR 1.51, 95% CI 1.40–1.62) and lower post-transition (IRR 0.88, 95% CI 0.83–0.93). The increase during transition was greater among men and with hemodialysis versus peritoneal dialysis. Risk also varied by calendar year of ESKD onset (Figure 2).
Conclusion
Gout flare risk increases markedly the first 90 days after dialysis initiation and declines thereafter with greater risk among men and hemodialysis. The transition to maintenance dialysis is a critical window for targeted monitoring and gout management.
Funding
- Other NIH Support