The rising global burden of gout attributable to kidney dysfunction: a 30-year trend analysis and projections to 2036.

BACKGROUND

Renal impairment and gout are mutually exacerbating conditions, yet the global burden of gout attributable to kidney dysfunction remains unquantified. This study examines trends in gout-related disability associated with renal impairment to inform global health strategies.

METHODS

Data were extracted from the global burden of disease (GBD) 2021. The age-standardized disability-adjusted life years (DALYs) rate and estimated annual percentage change (EAPC) were analysed. A Bayesian Age-Period-Cohort (BAPC) model was implemented to project disease burden. Health inequality analyses were conducted to assess absolute and relative inequalities across socio-demographic index (SDI) regions.

RESULTS

The global burden of gout attributable to renal impairment was estimated at 200,033 DALYs (95% Uncertainty Interval (UI): 125,245-296,812) globally. Age-standardized DALY rate increased from 1.47 (95% UI: 0.91-2.21) per 100,000 population in 1990 to 2.36 (95% UI: 1.48-3.50) in 2021 (EAPC 0.67). Significant geographical disparities were observed, with inequality analysis revealing a disproportionate concentration in high SDI regions. Male exhibited elevated age-standardized DALYs compared to females, with both genders exhibiting progressive age-dependent increases. Projection models indicated a potential decline trend in the global burden of renal impairment-associated gout.

CONCLUSIONS

This study systematically quantifies the global burden of gout attributable to renal impairment, revealing significant disparities across regions, genders, and age. The burden was predominantly concentrated in high-SDI regions, with male sex and advanced age identified as significant individual-level risk factors. These findings highlight the importance of tailored management strategies for high-risk populations, particularly elderly individuals with renal impairment. Key Points • An increasing global burden of gout attributable to renal impairment was observed from 1990 to 2021. Substantial geographical heterogeneity was noted across countries and regions, with the burden showing a positive correlation with the Socio-demographic Index. The disparity in disease burden between high and low SDI regions has continued to widen. • A distinct age-dependent increase in disease burden is observed among gout patients with renal impairment. Elderly individuals frequently present with multiple comorbidities, introducing complex challenges in clinical management. Enhanced screening and optimized treatment strategies for this population are urgently required. • Non-genetic determinants, including healthcare accessibility, diagnostic practices, environmental influences, and dietary patterns, may exert a more substantial influence on gout cases attributable to renal impairment. • Projection models indicate that the future global burden of gout attributable to renal impairment is likely to decline.