Disease
New Nationwide Survey on Gout Finds Patients with Gout and Chronic Kidney Disease are Sub-Optimally Treated
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Jan 17, 2018 - 10:10:56 AM

(HealthNewsDigest.com) - NEW YORK, Jan. 17, 2018 -- A new online survey was conducted by National Kidney Foundation (NKF) to determine what patients and health care professionals (HCP) know, or think they know, about gout; how professionals approach gout co-occurring with chronic kidney disease (CKD); and what barriers exist to diagnosing and treating gout once a patient is diagnosed with CKD.  In the United States alone, gout affects over 8 million adults and CKD affects 30 million. The survey found that patients with gout and CKD are sub-optimally treated, resulting in recurring painful attacks and possible long-term consequences. The survey polled 713 patients and health care professionals (HCP); 302 were medical professionals who provide primary or nephrology care to adults with CKD; and 411 were adults with CKD, gout/hyperuricemia, or both.

"The new survey on gout shows some important findings that can help guide conversations between patients and their health care professionals.  The survey shows that kidney patients want more information about gout and how to best treat it, but most are turning to the internet instead of their doctors for advice.  The survey also shows a need for professional education on the interrelationships between CKD and gout," said Joseph Vassalotti, MD, Chief Medical Officer, NKF.

Of the 302 medical professionals surveyed who provide primary or nephrology care to adults with CKD the survey found:

• Two-thirds of healthcare professionals (HCP) recognize that gout is closely related to CKD, which is much less than their recognition of the connection of CKD with hypertension and diabetes. More HCPs recognize the association of heart disease and lupus with CKD more than that between gout and CKD.
• Only three-quarters of nephrologists surveyed are aware that gout has a bidirectional relationship with CKD.
• Only 37% of HCPs strongly agree that CKD can make gout treatment more difficult.
• Only 21% of HCPs strongly agree that CKD patients often require different gout treatment.
• HCPs who are more knowledgeable about gout report screening approximately 10% more patients with CKD for gout and vice versa.

Of the 411 adult patients with CKD surveyed, the findings report:

• Two-thirds of patients say that gout affects their daily lives; one-third of patients say that gout greatly impacts their lives, and another third say it impacts their lives a fair amount. Almost half of the patients surveyed have had three or more gout flares in the past year, including 15% who have had five or more.
• Patient actions and physician recommendations regarding gout treatment are not always aligned. Three-quarters of patients say they take an over-the-counter (OTC) medication that was not recommended to them, and one-third of patients do not take the recommended prescription or OTC medications for gout.
• Patients are not getting complete information about gout and hyperuricemia from HCPs. Typically, 1 in 3 patients are given information specific to gout, other than the cause, which is only 51%.
• Three-quarters of patients are interested in seeing scientific details and references in health information, but over half want it in easier to understand, non-scientific language.
• Two-thirds of patients are turning to the internet for health information instead of their doctor.

"Kidney patients are at an increased risk for experiencing gout.  If left untreated gout can lead to permanent joint damage and increase the risk for kidney stones, which can cause kidney damage," added Dr. Vassalotti.  "The survey results bring attention to the impact of CKD and gout, two diseases that continue to increase in prevalence, exacting both a human and financial toll on society and our healthcare system."

About the Survey
The online clinician survey was conducted among 302 medical professionals who provide primary or nephrology care in the United Statesto adults with CKD.  The survey was focused on exploring their opinions and practices in testing and treating these patients for gout/hyperuricemia.  The online patient survey was conducted among 411 adults with chronic kidney disease, gout/hyperuricemia, or both.  The survey focused on exploring their awareness and experience related to gout and CKD.  The survey was made possible through an educational grant from Takeda.

About Gout
Gout is a painful disease that occurs when uric acid, a normal waste product, builds up in the blood and forms crystals in the joints and/or kidneys. Uric acid normally dissolves in the blood, is excreted by the kidney, and leaves the body in the urine. If the body makes extra uric acid, or if the kidneys cannot clear enough of it, then uric acid levels in the blood will become too high, a condition known as hyperuricemia. Hyperuricemia is not a disease and may not cause problems, but if it continues for a long time and conditions in the body are right, crystals may form and cause gout.  For people with gout most experts recommend that uric acid levels stay below 6.0 mg/dL in order to prevent gout joint attacks. Foods and drinks that contribute most to hyperuricemia and gout include: red meat, organ meat, seafood, beer, liquor, and sugar-sweetened items, especially with high fructose corn syrup. Health problems such as obesity, high blood pressure, high blood sugar, and high cholesterol may also lead to increased uric acid and the development of gout. Other causes of hyperuricemia and gout include kidney disease, exposure to lead, hypothyroidism, severe illness or stress, and extreme physical exertion. Some people with gout do not have high uric acid levels, so it is very important to maintain a healthy lifestyle no matter the level. Do not smoke, follow a well-balanced diet, maintain a healthy weight, and exercise. More information is available including videos, infographic, quick-facts, professional resources to educate patients, and an updated patient mobile app designed to help control gout and protect kidney function.

Kidney Disease Facts
30 million American adults are estimated to have chronic kidney disease—and most aren't aware of it.  1 in 3 American adults are at risk for chronic kidney disease.  Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history of kidney failure.  People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease.  African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end stage renal disease (kidney failure).

The National Kidney Foundation (NKF) is the largest, most comprehensive and longstanding organization dedicated to the awareness, prevention and treatment of kidney disease.  For more information about NKF visit www.kidney.org.

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