Oh Yoon-Jeong, Moon Ki Won
Division of Rheumatology, Department of Internal Medicine, Kangwon National University School of Medicine, 156, Baengnyeong-ro, Chuncheon-si, Gangwon-do, Republic of Korea.
Sci Rep. 2021 Mar 11;11(1):5684. doi: 10.1038/s41598-021-84980-6.
We aimed to compare clinical characteristics of patients with and without tophi at the time of the diagnosis of gout and investigate the association of tophi and renal function in gout patients. The patients who were first diagnosed with gout at the Kangwon National University Hospital were retrospectively studied. Patients were divided into 2 groups according to the presence of tophi at the diagnosis. We compared clinical characteristics and the progression of renal dysfunction between the two groups. Of 276 patients, 66 (25.5%) initially presented with tophi. Tophi group was older, had a longer symptom duration, and a higher prevalence of multiple joint involvement than those without tophi. In multivariate logistic regression analysis, prolonged symptom duration and multiple joint involvement were significantly associated with increased risk of formation of tophi. The decline in the eGFR was more prominent in patients with tophi than in those without (- 4.8 ± 14.5 vs. - 0.7 ± 11.9 ml/min/1.73 m/year, respectively; P = 0.039). The presence of tophi was significantly associated with a rapid decline in the eGFR (β = - 0.136; P = 0.042). In conclusion, the presence of tophi was associated with a rapid declining renal function. Therefore, an early diagnosis and closely monitoring of renal function might be important in gout patients with tophi.
我们旨在比较痛风诊断时有无痛风石患者的临床特征，并研究痛风患者中痛风石与肾功能的关系。对在江原国立大学医院首次诊断为痛风的患者进行回顾性研究。根据诊断时是否存在痛风石将患者分为两组。我们比较了两组患者的临床特征和肾功能不全的进展情况。在276例患者中，66例（25.5%）初诊时即有痛风石。痛风石组患者年龄更大，症状持续时间更长，多关节受累的患病率高于无痛风石患者。多因素逻辑回归分析显示，症状持续时间延长和多关节受累与痛风石形成风险增加显著相关。痛风石患者的估算肾小球滤过率（eGFR）下降比无痛风石患者更明显（分别为-4.8±14.5与-0.7±11.9 ml/min/1.73m²/年；P=0.039）。痛风石的存在与eGFR快速下降显著相关（β=-0.136；P=0.042）。总之，痛风石的存在与肾功能快速下降有关。因此，对于有痛风石的痛风患者，早期诊断并密切监测肾功能可能很重要。
