To test whether renal impairment protects from the development of gout.
We conducted a retrospective cohort study in which 40 hyperuricemic patients (serum uric acid > 0.54 mM/l) with renal impairment (serum creatinine > 200 microM/l) and 40 equally hyperuricemic patients with normal renal function (serum creatinine < 120 microM/l) were given a telephone questionnaire eliciting a history of gout, its pattern and severity, and other features of medical and family history.
There was no significant difference among the prevalence of gout (relative risk 1.1, confidence interval 0.73-1.67), the pattern and severity of gout, and the presence of tophi between the 2 groups. A positive family history of gout was significantly increased in the patients with gouty arthritis (p < 0.05).
Renal impairment does not protect from gout. There may be a familial factor in the development of gout that is independent from the familial tendency for hyperuricemia.