{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T22:28:49Z","timestamp":1792535329109,"version":"4.5.0"},"reference-count":44,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,7,29]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Evaluate the association between gout and risk of advanced chronic kidney disease (CKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective matched cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>UK Clinical Practice Research Datalink.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The analysis included data for 68\u2009897 patients with gout and 554\u2009964 matched patients without gout. Patients were aged \u226518 years, registered at UK practices, had \u226512 months of clinical data and had data linked with Hospital Episode Statistics. Patients were excluded for history of advanced CKD, juvenile gout, cancer, HIV, tumour lysis syndrome, Lesch-Nyhan syndrome or familial Mediterranean fever.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Advanced CKD was defined as first occurrence of: (1) dialysis, kidney transplant, diagnosis of end-stage kidney disease (ESKD) or stage 5 CKD (diagnostic codes in Read system or International Classification of Diseases, Tenth Revision); (2) estimated glomerular filtration rate (eGFR) &lt;10 mL\/min\/1.73 m\u00b2; (3) doubling of serum creatinine from baseline and (4) death associated with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Advanced CKD incidence was higher for patients with gout (8.54 per 1000 patient-years; 95% CI 8.26 to 8.83) versus without gout (4.08; 95%\u2009CI 4.00 to 4.16). Gout was associated with higher advanced CKD risk in both unadjusted analysis (HR, 2.00; 95%\u2009CI 1.92 to 2.07) and after adjustment (HR, 1.29; 95%\u2009CI 1.23 to 1.35). Association was strongest for ESKD (HR, 2.13; 95%\u2009CI 1.73 to 2.61) and was present for eGFR &lt;10\u2009mL\/min\/1.73\u2009m\u00b2 (HR, 1.45; 95%\u2009CI 1.30 to 1.61) and serum creatinine doubling (HR, 1.13; 95%\u2009CI 1.08 to 1.19) but not CKD-associated death (HR, 1.14; 95%\u2009CI 0.99 to 1.31). Association of gout with advanced CKD was replicated in propensity-score matched analysis (HR, 1.23; 95%\u2009CI 1.17 to 1.29) and analysis limited to patients with incident gout (HR, 1.28; 95%\u2009CI 1.22 to 1.35).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gout is associated with elevated risk of CKD progression. Future studies should investigate whether controlling gout is protective and reduces CKD risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-031550","type":"journal-article","created":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T08:11:45Z","timestamp":1566979905000},"page":"e031550","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Gout and the risk of advanced chronic kidney disease in the UK health system: a national cohort study"],"prefix":"10.1136","volume":"9","author":[{"given":"Austin G","family":"Stack","sequence":"first","affiliation":[{"name":"Graduate Entry Medical School & Health Research Institute, University of Limerick, Limerick, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle Elizabeth","family":"Johnson","sequence":"additional","affiliation":[{"name":"OXON Epidemiology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betina","family":"Blak","sequence":"additional","affiliation":[{"name":"AstraZeneca, Luton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Klein","sequence":"additional","affiliation":[{"name":"AstraZeneca, Gaithersburg, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis","family":"Carpenter","sequence":"additional","affiliation":[{"name":"OXON Epidemiology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Morlock","sequence":"additional","affiliation":[{"name":"YourCareChoice, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R","family":"Maguire","sequence":"additional","affiliation":[{"name":"OXON Epidemiology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria L","family":"Parsons","sequence":"additional","affiliation":[{"name":"OXON Epidemiology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,28]]},"reference":[{"key":"2025121603080511000_9.8.e031550.1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2010.02.001"},{"key":"2025121603080511000_9.8.e031550.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.17.2038"},{"key":"2025121603080511000_9.8.e031550.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041031"},{"key":"2025121603080511000_9.8.e031550.4","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1053\/j.ajkd.2007.05.013","article-title":"Relationship of uric acid with progression of kidney disease","volume":"50","author":"Chonchol","year":"2007","journal-title":"Am J Dis"},{"key":"2025121603080511000_9.8.e031550.5","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1053\/j.ajkd.2008.12.021","article-title":"Uric acid and long-term outcomes in CKD","volume":"53","author":"Madero","year":"2009","journal-title":"Am J Dis"},{"key":"2025121603080511000_9.8.e031550.6","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007101075"},{"key":"2025121603080511000_9.8.e031550.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0050046","article-title":"Reduced glomerular function and prevalence of gout: NHANES 2009-10","volume":"7","author":"Krishnan","year":"2012","journal-title":"PLoS One"},{"key":"2025121603080511000_9.8.e031550.8","doi-asserted-by":"crossref","unstructured":", et alPrevalence of CKD and uncontrolled gout among US adults: results from NHANES 2007-2012. 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