Musculoskeletal Ultrasound Evaluates Renal Injury and Predicts Renal Outcome in Patients with Gout

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Abstract

Introduction

Kidney injury diagnosis is often delayed in patients with gout. We aimed to determine the characteristics of gout patients with CKD using musculoskeletal ultrasound (MSUS) and whether MSUS could be used as an auxiliary assessment to evaluate kidney injury and predict renal outcome in patients with gout.

Methods

Clinical information, laboratory indicators, and MSUS findings were collected and compared between gout-only patients (gout − CKD) and gout patients with CKD (gout + CKD). Multivariate logistic regression was applied to identify risk factors for clinical and MSUS characteristics in both groups. Correlation analysis between MSUS signs and kidney-related indicators was performed, and the effects of MSUS characteristics on renal prognosis were evaluated.

Results

In total, 176 patients with gout were included, namely, 89 gout − CKD and 87 gout + CKD cases. After adjusting for confounders, the gout patients with CKD showed more frequent episodes in the previous year, higher ultrasound semiquantitative scores, and more tophi than gout patients without CKD. Additionally, the number of tophi, bone erosion, and synovial hypertrophy measured by MSUS was found to be negatively correlated with the eGFR. The existence of tophi was independently associated with an increased risk of a ≥10% decline in eGFR in the first-year follow-up (OR, 3.56; 95% CI, 1.382–9.176).

Conclusions

Ultrasound-detected tophi, bone erosion, and synovial hypertrophy were associated with kidney injury in gout patients. The existence of tophi was associated with faster renal function deterioration. MSUS could be a potential auxiliary diagnostic method to evaluate kidney injury and predict renal outcome in gout patients.

Related collections

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Author and article information

Journal

Journal ID (nlm-ta): Kidney Dis (Basel)

Journal ID (iso-abbrev): Kidney Dis (Basel)

Journal ID (publisher-id): KDD

Title: Kidney Diseases

Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )

ISSN (Print): 2296-9381

ISSN (Electronic): 2296-9357

Publication date Collection: April 2023

Publication date (Electronic): 21 November 2022

Publication date PMC-release: 21 November 2022

Volume: 9

Issue: 2

Pages: 94-103

Affiliations

[1] ^aDepartment of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China

[2] ^bInstitute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, China

[3] ^cGeneral Practice Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

[4] ^dDepartment of Ultrasound, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China

[5] ^eDepartment of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Author notes

*Niansong Wang, wangniansong2012@ 123456163.com

**Ying Fan, fanyingsh@ 123456126.com

Article

Publisher ID: kdd-0009-0094

DOI: 10.1159/000528200

PMC ID: 10091006

SO-VID: 996590e3-66b2-4248-801b-97ab3fc5f02f

License:

This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

History

Date received : 10 August 2022

Date accepted : 14 November 2022

Date: 2023

Page count

Figures: 3, Tables: 3, References: 30, Pages: 10

Funding

This work was supported by National Nature Science Foundation of China (82170727, 81870504 and 81870468), the Shanghai Jiao Tong University Gaofeng Talent Training Plan and a clinical project (20192833), Open Project of Shanghai Key Laboratory of Sleep Disordered Breathing (SHKSDB-KF-19-04), Three-Year Project of Shanghai TCM Development (ZT[2018-2020]-FWTX-2003), Star Program of Shanghai Jiao Tong University (20190102), and Open Project of National Science and Technology Infrastructure of translational medicine (Shanghai, TMSK-2021-109). The sponsors had no role in the design of the study; in the collection, analysis, and interpretation of data; in the writing of the article; and in the decision to submit the article for publication.

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