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A study on the risk factors for acute kidney injury in acute gouty arthritis

Xianzhen Zhang, Huaxiang Wu

Purpose: To study clinical characteristics of Acute Kidney Injury (AKI) in gouty arthritis.

Methods: A total of 199 individuals, who were diagnosed gouty arthritis cases at Tongde Hospital of Zhejiang Province. They were divided into two groups according to dynamics and serum creatinine changes. Their clinical manifestations, demographic data, complications, drugs usage and laboratory data were studied.

Results: Incidence of AKI was 11.1%. Compared with the non-AKI group, the AKI group had significantly higher basic serum creatinine levels 155.29 ± 44.39 vs. 107.25 ± 91.98, p<0.001 and higher level of urine N-acetyl-beta-D-glucosamidase (NAG) 27.44 ± 18.77 vs. 14.87 ± 10.42, p<0.001). There were significantly higher proportion of patients with Chronic Kidney Disease (CKD) in the AKI group (50% vs. 12.99%, p<0.001), higher proportion of patients with Ischemic Cardio-Cerebrovascular Disease (ICCVD) (40.91% vs. 14.12%, p=0.002) and higher proportion of Non-Steroidal Antiinflammatory Drugs (NSAIDs) users (72.73% vs. 48.59%, p=0.033). High urine NAG level (OR: 1.113, p<0.001) can independently reflect the occurrence of AKI. Logistic regression analysis showed that use of NSAIDs (OR: 6.054, p=0.031) and lower urine pH(acidity) (OR: 0.283, P=0.049) were high risk factors for AKI in gouty arthritis.

Conclusion: Low urine pH and the use of NSAIDs are major risk factors for AKI in gouty arthritis. These findings underscore the need to cause clinical attention and early prevention.