Background and Objectives: Gout is an inflammatory arthritis involving the deposition of uric crystals. It has been known to cause renal disease in the form of acute or chronic urate nephropathy, or urolithiases. Numerous studies have been published worldwide, defining proper handling and management of such cases. Despite such recommendations, the renal function of these patients complicates the management. Administration of the properly-adjusted medications and referrals to appropriate services are delayed because of lack of data at the patient’s initial visit. This study therefore aims to describe the renal function at index consult of Filipino patients with gout, and identify the factors that correlate with a depressed kidney function in such patients.

Methods: This study is a retrospective descriptive study involving gout patients seen in four rheumatology clinics. A total of 485 patients were identified. Records of the patients’ index consult, were reviewed. Demographic and disease characteristics were noted. Renal function was identified using the Cockroft-Gault equation for estimated glomerular filtration rate. Univariate analysis was done, characteristics of patients with good and poor renal function were compared.

Results: A total of 485 patients were studied. Most were males with presenting with a monoarticular joint involvement, with attacks occurring more than three times a year. Tophi were present in 28.2% of patients at the initial consult. The most commonly reported co-morbidity was hypertension. At index consult, the average serum creatinine and uric acid are 1.7mg/dL and 9.1 mg/ dL, respectively. The average creatinine clearance is 65.0±34.1 mL/min, and 51.3% presented with an eGFR of <60 mL/min at index consult. Poor renal function (eGFR <60mL/min) was associated with late onset (p<.0001) and prolonged disease duration (p<.0001), higher serum uric acid (p<.0001), a history of urolithiasis (p<.035), frequent attacks (p<.0001), with coexisting hypertension (p<.0001) or diabetes mellitus (p<.013). Interestingly, results also showed that females tend to have poorer renal function at index consult compared to males (p<.0001).

Conclusion: In this cohort of 485 Filipino patients with gout, 51.3% have eGFR<60 ml/min on first consultation. The clinical findings with significant associations with poor renal function should alert Filipino physicians to the high probability of renal disease among Filipino patients with gout and make the necessary adjustments in treatment plans.

Keywords: gout, renal disease, chronic kidney disease, hyperuricemia, renal function, initial visit

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