Researchers in Ireland have documented a substantial increase in the prevalence of hyperuricemia, especially among the most elderly patients and individuals with severely impaired renal function.
From 2006 to 2014, the prevalence of hyperuricemia increased from 19.7% to 25.0% among men and from 20.5% to 24.1% among women, a team led by Austin G. Stack, MD, of University Hospital Limerick and the Health Research Institute at the University of Limerick, reported in PLoS One.
The likelihood of hyperuricemia was greatest for patients in 2014. After adjusting for baseline demographic characteristics and illness indicators, men and women had significant 45% and 47% increased odds of hyperuricemia, respectively, in 2014 compared with 2006.
Hyperuricemia prevalence increased with age. In 2014, the prevalence was 18.6%, 20.2%, 27.7% and 43.0% among those aged 18 to 39, 40 to 59, 60 to 80, and older than 80 years, respectively. The corresponding percentages in 2006 were 13.7%, 16.5%, 24.1%, and 39.2%, respectively.
Hyperuricemia prevalence generally increased with decreasing kidney function. In 2014, the prevalence was 25.1%, 54.8%, 67.7%, and 48.9% among individuals aged 18 to 39, 40 to 59, 60 to 80, and older than 80 years, respectively. The corresponding percentages in 2006 were 19.2%, 48.3%, 75.2%, and 59.2%.
In multivariable analysis, individuals aged 40 to 59, 60 to 80, and more than 80 years had a significant 12%, 9%, and 27% increased risk of hyperuricemia, respectively, compared with those aged 18 to 39 years. Patients with an estimated glomerular rate (eGFR) of 60 to 89, 30 to 59, 15 to 29, and less than 15 mL/min/1.73 m2 had a 2.1, 8.0, 15, and 7.58 times increased risk of hyperuricemia, respectively, compared with individuals who had an eGFR of 90 mL/min/1.73 m2 or higher. Men had a significant 23% decreased likelihood of hyperuricemia compared with women.
Other factors significantly associated with an increased risk of hyperuricemia included elevated white cell count and higher hemoglobin levels.
The investigators determined hyperuricemia prevalence by analyzing data from 128,014 individuals aged 18 years or older in Ireland’s National Kidney Disease Surveillance Programme. Dr Austin’s group defined hyperuricemia as a serum uric level greater than 7 mg/dL in men and greater than 5.7 mg/dL in women.
Strengths of the study included a dataset that contained longitudinal data on all patients within a defined health system from 2006 to 2014, with serial measurements of serum uric acid. Another strength was the large sample size, which allowed the investigators “to carefully estimate prevalence with precision and map temporal trends in clearly defined demographic and clinical subgroups.”
With regard to study limitations, the investigators noted that their analysis was based on estimates derived from patients in Ireland’s health system and may not accurately reflect the true prevalence in the population.
Kumar A U A, Browne LD, Li X, et al. Temporal trends in hyperuricaemia in the Irish health System from 2006 – 2014: A cohort study. PLoS One. 2018;13(5):e0198197.