Frequency of Gouty Arthritis in Patients with End-stage Renal Disease in Japan

Abstract

Objective The purpose of this study was to investigate gouty arthritis in Japanese patients with end-stage renal disease (ESRD).Methods Questionnaires plus patient interviews and reviews of medical records were used to investigate gouty arthritis in 493 Japanese patients with ESRD receiving maintenance dialysis.Results The frequency of gouty arthritis was 4.1% for female patients and 15.4% for male patients greater than 2 years before the start of dialysis, and 0.6% for female patients and 7.7% for male patients less than 2 years before the start of dialysis. After the start of dialysis the frequency was 3.4% for the first 2 years and 1.2% thereafter in male patients, but no gouty arthritis appeared in female patients. Although the annual number of gouty attacks was 2.0±4.2 greater than 2 years before the start of dialysis, and 1.9±6.6 less than 2 years before the start of dialysis, the annual number of attacks decreased significantly after the start of dialysis to 0.2±0.7 in the first 2 years and 0.1±0.6 thereafter.Conclusions The frequency of gouty arthritis in Japanese patients with ESRD is similar to that of patients with hyperuricemia in the general population and it is decreased slightly before dialysis; however, the frequency decreases markedly after dialysis.

Population Pharmacokinetics and Therapeutic Efficacy of Febuxostat in Patients with Severe Renal Impairment

“…Since febuxostat has a high binding affinity (over 98%) to plasma proteins such as albumin, it is difficult to dialyze by the kidney or a dialysis membrane [10] . The frequency of gout arthritis in patients receiving maintenance dialysis was previously shown to be lower than that in the general population [28] . However, hyperuricemia is a risk factor for cardiovascular diseases [3,4] and should be treated in patients receiving dialysis.…”

Association of Incident Gout and Mortality in Dialysis Patients

“…These results contrast with previous smaller and single-center studies that found an infrequent rate of gout in dialysis patients. 1,2 The reasons for these disparities are not clear but may be related to the larger number of patients sampled or differences in lifestyle/diet. It is also likely that a significant number of patients with ESRD had a predialysis episode of gout that could not be identified because of the inherent limitations of an observational study.…”

“…1,2 The available research is limited by small sample sizes. The incidence of gout in dialysis patients is believed to be rare.…”

“…The incidence of gout in dialysis patients is believed to be rare. 1,2 A study from Japan revealed a 2.8% frequency of gout after the initiation of renal replacement therapy. 2 Ifudu et al 1 reported no new cases of gout after the start of dialysis.…”

“…5,15 Nevertheless, preliminary data suggest that the incidence of gout in patients with ESRD may be low, perhaps secondary to clearance of inflammatory mediators on hemodialysis (HD). 2 The association of gout with survival and other demographic factors including gender, age, race, and body mass index (BMI) has not been reported in a large population-based study of patients with ESRD. Previous studies of general medical patients showed an increased risk for cardiovascular mortality in patients with a diagnosis of gout.…”