Older age, previous kidney transplant, and comorbid hypertension are significantly associated with an increased risk for gout among patients on dialysis, according to study findings presented at the American Society of Nephrology’s Kidney Week 2021.

The study also revealed that patients on dialysis who have gout have higher erythropoiesis-stimulating agent (ESA) requirements, higher ferritin levels, and lower transferrin saturation, “implicating gout’s impact on erythropoiesis possibly due to chronic systemic inflammation,” Anthony J. Bleyer, MD, of Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues reported in a poster presentation.

The investigators analyzed US Renal Data System data on 275,651 patients receiving dialysis, of whom 41,312 (15%) had gout and 234,339 (85%) did not. Compared with non-gout patients, the patients with gout were older (mean age 63.5 vs 56.8 years), male (62% vs 54%) and obese (mean body mass index 31.4 vs 30.2 kg/m2). Patients with gout had a higher incidence of hospitalizations (66.3% vs 56.9%) and a greater prevalence of cardiovascular disease (CVD), including heart failure (49% vs 30%), ischemic heart disease (49% vs 30%), peripheral vascular disease (32% vs 22%, acute myocardial infarction (7% vs 3%), and angina (4% vs 2%), Dr Bleyer’s team reported in a poster presentation.

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Compared with patients younger than 65 years, those aged 65 years or older had 4.2-fold increased odds of gout, in adjusted analyses. Patients with a previous kidney transplant and those with comorbid hypertension had significant 2.4- and 2.7-fold increased odds of gout, respectively. 

In adjusted analyses, gout was significantly associated with a 9% increased risk for death and an 11% increased risk for a composite of CVD-hospitalization and death.

“Our study strengthens the evidence for gout as a risk factor for CVD and kidney disease mortality,” Dr Bleyer told attendees. “Increased awareness of risk factors for gout in patients on dialysis such as a higher frequency in males and the elderly as well as association to comorbidities such as obesity and cardiovascular disease may assist in the diagnosis of gout and improve clinical outcomes.”

This research was supported by Horizon Therapeutics. Please see the original reference for a full list of disclosures.


Bleyer AJ, Zhang Y, Kshirsagar O, Marder, LaMoreaux B. Risk factors and outcomes of gout in dialysis patients: A cohort study of the United States Renal Data System (USRDS). Presented at: Kidney Week 2021, November 2-7, 2021. Poster PO0792.