Incidence of and risk factors for nephrolithiasis in patients with gout and the general population, a cohort study

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Created On: 15/02/2020

Incidence of and risk factors for nephrolithiasis in patients with gout and the general population, a cohort study

Nephrolithiasis (NL) is comprehended to be correlated with gout; but, the comparative studies on risk and risk factors for NL in gout were minimum.

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Key take away

Nephrolithiasis is a painful condition in which solid material stones get deposited in the kidney. There are a few studies in history that explain the association and risk of nephrolithiasis in gout patients. In this study, the incidence rate and risk factors of nephrolithiasis have been determined in gout patients, and various demographic characteristics of patients like age and sex were found to increase the risk of NL in patients with gout.

Background

Nephrolithiasis (NL) is comprehended to be correlated with gout; but, the comparative studies on risk and risk factors for NL in gout were minimum. This analysis evaluated (a) overall rate of NL in gout (cases) and general population controls; (b) risk and risk factors for first-time NL in cases and controls independently.

Method

The regional healthcare database in western Sweden (VEGA) was used to found the patients and sex and age-matched controls. The investigated risk factors like comorbidities and current medication use for socioeconomic factors and first-time NL were recovered from VEGA and other national Swedish registers. For patients, follow up started on 1 January 2006 or on the first examination of gout if this appeared later, and for controls on their index patient's first investigation of gout. Follow up closed on death, withdrawal or 31 December 2012. The incidence calculations were implemented for patients and their controls. HRs with the first episode of NL, as a result, was assessed only in those without previous NL.

Result

The patients exhibited 678 NL events and controls 2125 NL events, appearing in an age-sex-adjusted prevalence rate ratio of 1.60. Besides for a considerable interaction for losartan which raised the risk of NL only in controls, both groups showed similar point estimates for predictive factors.

With the introduction of Loop diuretics, the risk of NL significantly decreased by 30–34% in both groups. Further notable predictors of NL in gout patients were obesity, diabetes, and male sex and in controls kidney disease and male sex.