AIM To determine the impact of allopurinol non-adherence as a proxy for uncontrolled disease on primary prevention of end-stage renal disease(ESRD).METHODS A cohort of 2752 patients with gout diagnosis was reconstruct...AIM To determine the impact of allopurinol non-adherence as a proxy for uncontrolled disease on primary prevention of end-stage renal disease(ESRD).METHODS A cohort of 2752 patients with gout diagnosis was reconstructed using the Québec Régie de l'assurance maladie du Québec and MedE cho administrative databases.Eligible patients were new users of allopurinol,aged 45-85,with a diagnosis of hypertension,and treated with an antihypertensive drug between 1997 and 2007.RESULTS Major risk factor for ESRD onset was chronic kidney disease at stages 1 to 3 [rate ratio(RR) = 8.00;95% confidence interval(CI):3.16-22.3 and the severity of hypertension(≥ 3 vs < 3 antihypertensives)] was a trending risk factor as a crude estimate(RR = 1.94;95%CI:0.68-5.51).Of 341 patients,cases(n = 22) and controls(n = 319),high adherence level(≥ 80%) to allopurinol therapy,compared with lower adherence level(< 80%),was associated with a lower rate of ESRD onset(RR = 0.35;95%CI:0.13-0.91).CONCLUSION Gout control seem to be associated with a significantdecreased risk of ESRD onset in hypertensive populations,further research should be conducted confirming this potential associated risk.展开更多
文摘AIM To determine the impact of allopurinol non-adherence as a proxy for uncontrolled disease on primary prevention of end-stage renal disease(ESRD).METHODS A cohort of 2752 patients with gout diagnosis was reconstructed using the Québec Régie de l'assurance maladie du Québec and MedE cho administrative databases.Eligible patients were new users of allopurinol,aged 45-85,with a diagnosis of hypertension,and treated with an antihypertensive drug between 1997 and 2007.RESULTS Major risk factor for ESRD onset was chronic kidney disease at stages 1 to 3 [rate ratio(RR) = 8.00;95% confidence interval(CI):3.16-22.3 and the severity of hypertension(≥ 3 vs < 3 antihypertensives)] was a trending risk factor as a crude estimate(RR = 1.94;95%CI:0.68-5.51).Of 341 patients,cases(n = 22) and controls(n = 319),high adherence level(≥ 80%) to allopurinol therapy,compared with lower adherence level(< 80%),was associated with a lower rate of ESRD onset(RR = 0.35;95%CI:0.13-0.91).CONCLUSION Gout control seem to be associated with a significantdecreased risk of ESRD onset in hypertensive populations,further research should be conducted confirming this potential associated risk.