Using 2017 USRDS data, researchers identified dialysis patients aged 18 and older with Medicare as the primary payer. Baseline characteristics and comorbid conditions for patients with gout who were dialysis-dependent were assessed at dialysis initiation as well as 3 months preceding their gout diagnosis and compared with those of patients without gout receiving dialysis. All-cause hospitalization and mortality risk were also estimated and compared between patients with and without gout. Of 275,651 patients receiving dialysis in 2017, 15% had one or more gout claims following initiation of chronic outpatient dialysis. More than one-third of gout diagnoses were made by internal and family medicine physicians. Compared with patients without gout, those with the condition were more likely to be older (mean age, 64.5 vs 56.8), male (62% vs 54%), of Asian race (6.2% vs 3.7%), and obese (31.4 vs 30.2 kg/m2). Patients with gout were also more likely to undergo hemodialysis via central venous catheter (15% vs 13%) and had a higher comorbidity prevalence of diabetes (67% vs 62%), hypertension (93% vs 74%), and cardiovascular conditions (heart failure [49% vs 30%], ischemic heart disease [49% vs 30%], peripheral vascular disease [32% vs 22%], stroke [12% vs 8%], acute myocardial infarction [7% vs 3%] and angina [4% vs 2%]). Adjusted regression analysis showed that older age (OR, 4.23 for age ≥65 vs <65), previous transplant (OR, 2.37), and comorbid hypertension (OR, 2.71) were the three most significant factors associated with gout diagnosis. In multivariate analysis, risks for hospitalization and mortality were higher by 11% and 9%, respectively, in the year after diagnosis.
