An Investigation Of Hyperuricemia And Gout Attack In Inpatients With Chronic Kidney Disease

Objective: Objective to investigate the prevalence of hyperuricemia and gout in inpatients with chronic kidney disease,and to analyze the influencing factors.Methods: Collection of all clinical data of patients who diagnosed chronic kidney disease in the Department of Nephrology,and who diagnosed gout without CKD in the Department of Endocrinology,the Department of Rheumatism of the First Affiliated Hospital of Fujian Medical University from Jan 2003 to Dec 2015,and of the physical population met the standard set of the subject from Oct to Dec 2008.The patients were divided into 4 groups: class CKD without gout,class CKD with gout,class physical population without CKD or gout,class gout without CKD.ANOVO,Kruskal-Wallis Test or chi-square test were used to investigate the difference of the case history and laboratory indexes.Scatter plot and correlation analysis were used to explore the correlation between the laboratory indexes.Binary Logistic Analysis was used to find the risk factors of chronic kidney disease and gout.Results: 1.Included in the analysis of 1101 cases of the CKD without gout,male in 667 cases,female in 434 cases,male: female was 1.54:1.The overall level of uric acid was 479.60±130.41mmol/l,491.35±129.01mmol/l for male,461.53±130.62mmol/l for female,there was a statistical difference between men and women in the levels of uric acid(P<0.05);the total prevalence of HUA was 74.59%,the prevalence of male was 72.13%,female prevalence was 78.34%,the prevalence of HUA between men and women was statistically different(P=0.020).2.Included in the analysis of 1804 cases of the physical population without CKD or gout,male in 1056 cases,female in 748 cases,male: female was 1.41:1.The overall level of uric acid was 327.77±78.28mmol/l,368.54±67.20mmol/l for male,270.22±52.40mmol/l for female,there was a statistical difference between men and women in the levels of uric acid(P<0.05);the total prevalence of HUA was 14.02%,the prevalence of male was 19.89%,female prevalence was 5.75%,the prevalence of HUA between men and women was statistically different(P<0.05).3.Included in the analysis of 114 cases of the gout with CKD,male in 121 cases,female in 23 cases,male: female was 5.26:1.The overall level of uric acid was 560.88±134.34mmol/l,564.64±132.11mmol/l for male,541.02±147.05mmol/l for female,there was no statistical difference between men and women in the levels of uric acid(P=0.441);the total prevalence of HUA was 86.11%,the prevalence of male was 85.12%,female prevalence was 91.30%,the prevalence of HUA between men and women was not statistically different(P=0.648).4.Included in the analysis of 102 cases of the gout without CKD,male in 93 cases,female in 9 cases,male: female was 10.33:1.The overall level of uric acid was 432.47±134.20mmol/l,437.50±132.42mmol/l for male,380.47±149.68mmol/l for female,there was no statistical difference between men and women in the levels of uric acid(P=0.225);the total prevalence of HUA was 55.89%,the prevalence of male was 54.84%,female prevalence was 66.67%,the prevalence of HUA between men and women was not statistically different(P=0.741).5.The levels of uric acid of the CKD without gout is higher than the physical population without CKD or gout's(479.60 ± 130.41?mol/L vs 327.77 ±78.28?mol/L,P<0.05),and the prevalence of HUA is also higher(74.59% vs 14.02%,P<0.05);the levels of uric acid of the CKD with gout is higher than the gout without CKD(560.88±134.34?mol/L vs 432.47±134.20?mol/L,P<0.05),and the prevalence of HUA is also higher(86.11% vs 55.89%,P<0.05);the levels of uric acid of the CKD with gout is higher than the CKD without gout(560.88±134.34?mol/L/l vs 479.60±130.41?mol/L,P<0.05),and the prevalence of HUA is also higher(86.11% vs 74.59%,P=0.002);the levels of uric acid of the gout without CKD is higher than the physical population without CKD or gout's(432.47 ± 134.20?mol/L vs 327.77 ± 78.28?mol/L,P<0.05),and the prevalence of HUA is also higher(55.89% vs 14.02%,P<0.05).6.Uric acid was positively correlated with creatinine(P<0.05,r=0.344)in non-gout patients with CKD;uric acid was positively correlated with creatinine(P<0.05,r=0.611)in the physical population without CKD or gout;uric acid was positively correlated with creatinine(P<0.05,r=0.363)in the CKD with gout;there was not a statistical correlation between uric acid and creatinine in the gout without CKD(P=0.075).7.In the patients without gout,the risk factors of CKD are age,hyperuricemia,diabetes mellitus and hypertension,the protective factors of CKD are HDL;in the patients with gout,the risk factors of CKD are hyperuricemia and hypertension,the protective factors of CKD are albumin;in the patients with CKD,the risk factors of gout are male,potation and hyperuricemia,the protective factors of gout are HDL;in the patients without CKD,the risk factors of gout are male,diabetes mellitus and hyperuricemia,the protective factors of gout are HDL.Conclusions: 1.In the group without gout,the levels of uric acid and the prevalence of HUA in man are significantly higher than these in woman,while there are no statistical difference in the group with gout;gout attacking in the patient with CKD has its particularity: the levels of uric acid is higher in the patient with CKD when the gout attacking.2.Uric acid is positively correlated with creatinine in the CKD.3.Hyperuricemia is an independent risk factor for CKD.