Incident gout and chronic Kidney Disease: healthcare utilization and survival

BMC Rheumatology

Alyssa B. Klein¹  Yair Molad²  Hagit Gabay³  Maya Leventer-Roberts³  Becca Feldman³  Shmuel M. Giveon³  Arriel Benis³  Dana Y. Teltsch⁴  Dena H. Jaffe⁵  Natalia M. Flores⁵  Jonathan Chapnick⁵  Robert Morlock⁶ 

[1] AstraZeneca, Medical Evidence and Observational Research Centre;Beilinson Hospital, Rabin Medical Center and Sackler Faculty of Medicine, Tel Aviv University;Clalit Research Institute;Evidera;Kantar Health;YourCareChoice;

关键词: Gout;    Chronic kidney disease;    Healthcare utilization;    Survival;   

DOI  :  10.1186/s41927-019-0060-0

来源: DOAJ

【 摘 要 】

Abstract Background Uncontrolled gout can cause significant joint and organ damage and has been associated with impairments in quality of life and high economic cost. Gout has also been associated with other comorbid diseases, such as chronic kidney disease. The current study explored if healthcare resource utilization (HRU) and survival differs between patients with incident gout in the presence or absence of chronic kidney disease (CKD). Methods Clalit Health Services (CHS) data were used to conduct a retrospective population-based cohort study of incident gout between 1/1/2006–31/12/2009. Incident cases of gout were identified and stratified by CKD status and by age group (< 55 and 55+ years). CKD status was defined as a pre-existing diagnosis of chronic kidney disease, chronic renal failure, kidney transplantation, or dialysis at index date. Demographic and clinical characteristics, as well as healthcare resource use, were reported. Results A total of 12,940 incident adult gout patients, with (n = 8286) and without (n = 4654) CKD, were followed for 55,206 person-years. Higher rates of HRU were observed for gout patients with CKD than without. Total annual hospital admissions for patients with gout and CKD were at least 3 times higher for adults < 55 (mean = 0.51 vs 0.13) and approximately 1.5 times higher for adults 55+ (mean = 0.46 vs 0.29) without CKD. Healthcare utilization rates from year 1 to year 5 remained similar for gout patients < 55 years irrespective of CKD status, however varied according to healthcare utilization by CKD status for gout patients 55+ years. The 5-year all-cause mortality was higher among those with CKD compared to those without CKD for both age groups (HR< 55 years = 1.65; 95% CI 1.01–2.71; HR55+ years = 1.50; 95% CI 1.37–1.65). Conclusions The current study suggests important differences exist in patient characteristics and outcomes among patients with gout and CKD. Healthcare utilization differed between sub-populations, age and comorbidities, over the study period and the 5-year mortality risk was higher for gout patients with CKD, regardless of age. Future work should explore factors associated with these outcomes and barriers to gout control in order to enhance patient management among this high-risk subgroup.

【 授权许可】

Unknown