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Associated gout comorbidities

Comorbidities are common in patients with gout, according to the 2007–2008 National Health and Nutrition Examination Survey data4

74%

had hypertension

71%

had stage 2* or greater chronic kidney disease

53%

were obese†

26%

had diabetes

14%

had a history of myocardial infarction

10%

had a history of stroke

*eGFR >60 mL/min/1.73 m2.
†>30 kg/m2.

What organs does gout affect?
Heart

Is gout related to heart disease?

Uric acid is a risk marker for coronary heart disease (CHD)5-7
And is also a durable independent marker of risk for the development of hypertension5-7
  • A meta-analysis of 9 studies with 25,229 patients with confirmed or suspected CHD suggested there was a ~2x greater risk of cardiovascular mortality in patients with high sUA compared to patients with low sUA levels8
  • The adjusted hazard ratio (HR) for cardiovascular disease risk is 1.49 (95% CI, 1.43-1.56) in gout patients compared to nongout patients9
  • Gout patients were shown to be at 50% greater risk of coronary artery disease (per data from an analysis of 70,000 patients)9

DECT scan: urate crystal deposition in the wall of the aortic arch.

A DECT scan showing urate crystal deposition in the wall of the aortic arch in the heart of a gout patient, with crystal microscopy

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DECT scan: urate crystal deposition in the wall of the aortic arch.

A DECT scan showing urate crystal deposition in the wall of the aortic arch in the heart of a gout patientA DECT scan showing urate crystal deposition in the wall of the aortic arch in the heart of a gout patient

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DECT scan: urate crystal deposition in the wall of the aortic arch.

A DECT scan with an arrow showing urate crystal deposition in the aortic archA DECT scan with an arrow showing urate crystal deposition in the aortic arch

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In this vodcast, learn about potential
dangers of urate deposition in the heart

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Kidneys

Is gout related to kidney disease?

Gout has been shown to be an independent risk factor for the onset and progression of chronic kidney disease (CKD)6,10,11
  • Patients with gout and sUA of >7 mg/dL had a 43% higher risk of kidney disease than patients with gout who had lower sUA levels (HR, 1.43: 95% CI, 1.20-1.70)12
  • Patients with hyperuricemia are at higher risk for acute kidney injury (AKI). Episodes of AKI have been associated with CKD13
Patients with moderate to severe CKD have a 10-fold increase in gout prevalence.14

DECT scan: red dots represent urate crystal deposition in the renal medulla.

Medical imaging showing urate crystal deposition in the renal medulla of the kidneys in gout patient

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DECT scan: red dots represent urate crystal deposition in the renal medulla.

Medical imaging showing urate crystal deposition in the kidneys of gout patientMedical imaging showing urate crystal deposition in the kidneys of gout patient

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Renal stones in the collecting system of the kidneys.

An image of renal stones in the collecting systems of the kidneys in gout patientAn image of renal stones in the collecting systems of the kidneys in gout patient

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Renal urate deposits as thin yellow streaks within the renal medulla.

An image of renal urate deposits within the renal medulla in gout patientAn image of renal urate deposits within the renal medulla in gout patient

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Watch “Urate in the kidneys? No kidding!”

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Eyes

Does gout affect the eyes?

Urate deposition in the eye15
Patients with long-term gout for more than 5 years were found to have twice the prevalence of dilated and tortuous blood vessels versus nongout patients16*

Urate crystal deposition has been observed in almost all ocular and adrenal locations, including17:

  • Eyelid
  • Conjunctiva
  • Sclera
  • Cornea
  • Lens
  • Iris
  • Orbit
  • Vitreous chamber
  • Optic disk
  • Retina

*Based on a study of 380 gout patients.

Coronal urate crystal deposition in the cornea and superficial
sclera of the eye.

A photo of urate crystal deposits from gout in eye of patient, with an arrow pointing to the cornea and superficial sclera

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Coronal urate crystal deposition in the cornea and superficial
sclera of the eye.

A photo of urate crystal deposits from gout in eye of patient, with an arrow pointing to the superficial sclera

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Urate crystal deposition on the iris and anterior chamber
of the left eye.

A photo of urate crystal deposits from gout on the iris and anterior chamber of the left eye

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In this vodcast, learn what can result from
urate deposition in the eyes

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Learn more about urate deposition in the bones

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References

  1. Nickeleit V, et al. Nephrol Dial Transplant. 1997;12(9):1832-1838.
  2. Klauser AS, et al. JAMA Cardiol. 2019;4(10):1019-1028.
  3. Khanna PP, et al. J Clin Med. 2020;9(10):3204.
  4. Zhu Y, et al. Am J Med. 2012;125(7):679-687.
  5. Clarson LE, et al. Ann Rheum Dis. 2015;74(4):642-647.
  6. Bardin T, et al. BMC Med. 2017;15(1):123.
  7. Choi HK, et al. Am J Med. 2007;120(5):442-447.
  8. Lee SJ, et al. Clin Hypertens. 2020;26:13.
  9. Huang WS, et al. J Investig Med. 2020;68(5):972-979.
  10. Roughley M, et al. Arthritis Res Ther. 2018;20(1):243.
  11. Stack AG, et al. BMJ Open. 2019;9(8):e031550.
  12. Krishnan E, et al. J Rheumatol. 2013;40(7):1166-1172.
  13. Xu X, et al. BMC Nephrol. 2017;18(1):27.
  14. Krishnan E. PLoS One. 2012;7(11):e50046.
  15. Sharon Y, et al. Curr Rheumatol Rep. 2016;18(6):37.
  16. Lin J, et al. Int J Ophthalmol. 2013;6(3):307-311.
  17. Ao J, et al. Clin Exp Ophthalmol. 2017;45(1):73-80.