Gout after living kidney donation: Correlations with demographic traits and renal complications

Ngan N. Lam, Amit X. Garg, Dorry L. Segev, Mark A. Schnitzler, Huiling Xiao, David Axelrod, Daniel C. Brennan, Bertram L. Kasiske, Janet E. Tuttle-Newhall, Krista L. Lentine

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

The demographic and clinical correlates of gout after living kidney donation are not well described. Methods: Using a unique database that integrates national registry identifiers of U.S. living kidney donors (1987-2007) with billing claims from a private health insurer (2000-2007), we identified post-donation gout based on medical diagnosis codes or pharmacy fills for gout therapies. The frequencies and demographic correlates of gout after donation were estimated by Cox regression with left-and right-censoring. We also compared the rates of renal diagnoses among donors with and without gout, matched in the ratio 1:3 by age, sex, and race. Results: The study sample of 4,650 donors included 13.1% African Americans. By seven years, African Americans were almost twice as likely to develop gout as Caucasian donors (4.4 vs. 2.4%; adjusted hazard ratio, aHR, 1.8; 95% confidence interval (CI) 1.0-3.2). Post-donation gout risk also increased with older age at donation (aHR per year 1.05) and was higher in men (aHR 2.80). Gout rates were similar in donors and age-and sex-matched general non-donors (rate ratio 0.86; 95% CI 0.66-1.13). Compared to matched donors without gout, donors with gout had more frequent renal diagnoses, reaching significance for acute kidney failure (rate ratio 12.5; 95% CI 1.5-107.0), chronic kidney disease (rate ratio 5.0; 95% CI 2.1-11.7), and other disorders of the kidney (rate ratio 2.2; 95% CI 1.2-4.2). Conclusion: Donor subgroups at increased risk of gout include African Americans, older donors, and men. Donors with gout have a higher burden of renal complications after demographic adjustment.

Original languageEnglish (US)
Pages (from-to)231-240
Number of pages10
JournalAmerican Journal of Nephrology
Volume41
Issue number3
DOIs
StatePublished - May 28 2015

Keywords

  • Cohort study
  • Gout
  • Health administrative data
  • Health outcomes
  • Kidney disease
  • Living kidney donors
  • Pharmacy claims
  • Registries

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