Interactions Between Gout and Chronic Kidney Disease: A Systematic Review

Abstract

Despite the recognized clinical overlap between gout and chronic kidney disease (CKD), a comprehensive synthesis of the evidence regarding their intricate relationship, encompassing disease prevalence, risk of progression, and associated outcomes, remains crucial. This systematic review aims to synthesize existing evidence on the association between gout and CKD, focusing on these key aspects. A comprehensive search of four databases led to the discovery of 816 relevant publications. After eliminating duplicates and assessing each article for relevance, 51 full-text articles were examined, and ultimately, 9 studies were selected based on the inclusion criteria. Nine studies were included, with a total of 190,760 gout patients and 133,015 (69.7%) were males. The prevalence of CKD among gout patients ranged from 16.2% to 84.1%. Adjusted hazard ratios for incident or progressive CKD ranged from 1.28 to 3.05, confirming a significantly increased risk in gout patients. Elevated serum uric acid levels were associated with worse renal function, while achieving target urate levels (<6 mg/dL) was linked to a reduced risk of end-stage kidney disease. Patients with both gout and CKD had higher healthcare utilization and increased mortality. Gout appears to be a clinically relevant risk factor for the development and progression of CKD. Routine renal screening and effective urate-lowering therapy may play a critical role in mitigating renal outcomes and improving the overall prognosis of this high-risk patient population.