Features of cardiorenal comorbidity in patients with different urate status in outpatient practice
Introduction. Hyperuricemia (HU) is an independent predictor of the development and adverse course of a number of life-threatening conditions. An in-depth analysis of the structure and characteristics of comorbidity will allow us to move beyond general concepts of increased risk to the development of personalized treatment algorithms, early diagnosis, and preventive interventions for patients with HU. Objective: To evaluate the characteristics of cardiorenal comorbidity in patients with different urate status. Material and methods. A retrospective, cross-sectional study was conducted analyzing the medical records of 6,105 patients divided into three groups: those with a normal uric acid level (n = 1,999), those with HU (n = 2,176), and those with a diagnosis of gout (n = 1,930). In addition to standard group comparisons, a stratified analysis by gender and age was performed to assess the incidence of key complications: chronic kidney disease (CKD), atrial fibrillation, chronic heart failure (CHF), and myocardial infarction. Statistical analysis included calculation of odds ratios with 95% confidence intervals and comparison of distributions using the χ² test. Results. Patients with HU and gout have a distinct risk gradient for cardiorenal complications. The prevalence of CKD was 2.7 times higher in the HU group and 4 times higher in the gout group than in normouricemia (24.1, 35.5, and 8.8%, respectively, p <0.001). Men with HU are significantly more likely to develop myocardial infarction, while women with HU and gout have a higher relative risk of developing CHF and CKD. Severe complications (CHF, coronary heart disease) develop at a younger age in the gout group than in the general population. Conclusion. HU, especially when transformed into gout, is a powerful independent factor in the early and aggressive development of cardiorenal pathology with significant gender and age specificities. The data obtained indicate the need for a differentiated approach to screening and active preventive strategies, starting from the asymptomatic stage of HU.T.E. Morozova, A.A. Karakhanian, A.A. Gertsog, E.O. Samokhina
Keywords
hyperuricemia
gout
uric acid
cardiorenal risk
chronic kidney disease
gender differences
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About the Authors
Tatiana E. Morozova, MD, Dr. Sci. (Medicine), professor, head of the Department of general medical practice, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.E-mail: morozova_t_e@staff.sechenov.ru
ORCID: https://orcid.org/0000-0002-3748-8180. Scopus ID: 7102299240. eLibrary SPIN: 7917-1951
Anna A. Karakhanian, MD, postgraduate student of the Department of general medical practice, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
E-mail: Karakhanian193@yandex.ru
ORCID: https://orcid.org/0009-0003-6093-450X
Anna A. Gertsog, MD, PhD (Medicine), assistant at the Department of general medical practice, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
E-mail: gertsog_a_a@staff.sechenov.ru
ORCID: https://orcid.org/0000-0002-3324-5472. Scopus ID: 57225905122. eLibrary SPIN: 7538-3299
Elena O. Samokhina, MD, PhD (Medicine), associate professor of the Department of general medical practice, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
E-mail: samokhina_e_o_1@staff.sechenov.ru
ORCID: https://orcid.org/0000-0001-6550-2915. Scopus ID: 57221997009. eLibrary SPIN: 5261-0545
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