{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:24:02Z","timestamp":1791329042991,"version":"4.3.1"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,11,27]],"date-time":"2013-11-27T00:00:00Z","timestamp":1385510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The kidney is the major organ that facilitates excretion of urate in humans. Surprisingly, few studies have assessed whether a reduced glomerular filtration rate (GFR) and\/or kidney damage is associated with a higher incidence of gout, and this study was undertaken to address this question.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from a 7\u2010year followup of patients enrolled in the Multiple Risk Factor Intervention Trial, a primary prevention trial for cardiovascular disease among 12,866 men ages 35\u201357 years, were used for the present investigation. Presence of gout was determined by the study physicians from the original trial. Chronic kidney disease was defined using criteria similar to those proposed by the National Kidney Foundation. The Cox proportional hazards regression model was used to assess the association between gout and chronic kidney disease, after accounting for the effects of potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, there were 722 cases of physician\u2010 diagnosed incident gout over 76,602 person\u2010years of followup. The standardized incidence ratio of gout among those with chronic kidney disease was 1,217 (95% confidence interval [95% CI] 1,191\u20131,244). The adjusted hazard ratio (HR) among those with chronic kidney disease was 1.61 (95% CI 1.60\u20131.61). Each standard deviation decline in the estimated GFR was associated with an HR of 1.43 (95% CI 1.35\u20131.51). Including the serum urate level, as well as the urate\u2013chronic kidney disease interaction term, as variables in the second analysis did not attenuate the HR. Proteinuria and hematuria, two markers of kidney damage, were associated with an elevated risk of gout independent of the estimated GFR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chronic kidney disease manifesting as reduced glomerular function or as presence of blood or protein in the urine increases the risk of incident gout.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.38171","type":"journal-article","created":{"date-parts":[[2013,8,27]],"date-time":"2013-08-27T20:50:42Z","timestamp":1377636642000},"page":"3271-3278","source":"Crossref","is-referenced-by-count":48,"title":["Chronic Kidney Disease and the Risk of Incident Gout Among Middle\u2010Aged Men: A Seven\u2010Year Prospective Observational Study"],"prefix":"10.1002","volume":"65","author":[{"given":"Eswar","family":"Krishnan","sequence":"first","affiliation":[{"name":"Stanford University School of Medicine Stanford 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