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Pattern of gout and its association with chronic kidney disease in Maiduguri, northeastern Nigeria

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Abstract

Introduction

Gout is considered uncommon among Black Africans. It is commoner in men and associated with obesity, hypertension, and chronic kidney disease (CKD). This study aims to determine the pattern and frequency of gout and its associated factors in Maiduguri, north-eastern Nigeria.

Method

A retrospective study of gout patients managed at the rheumatology clinic of the University of Maiduguri Teaching Hospital (UMTH), Nigeria, from January 2014 to December 2021. Diagnosis of gout was made using the Netherlands 2010 criteria, and CKD was defined as an estimated glomerular filtration rate (eGFR) of < 60 ml/min/1.73m2 using the 2021 CKD-epidemiology collaboration (CKD-EPI) creatinine equation. A P-value of < 0.05 was considered statistically significant.

Results

Out of 1409 patients seen during the study period, 150 (10.7%) had gout. They comprised 57.0% males, mostly presented with mono-articular disease (47.7%) with the ankle predominantly involved (52.3%). First metatarsophalangeal and knee joint involvement were commoner among males than females (59% vs 39%, p = 0.052 and 55.7% vs 34.8%, p = 0.05 respectively). The mean serum uric acid (SUA) level was 557.6 ± 176.2 mmol/l, and the levels did not differ between gender (p = 0.118, CI [− 126.6 to 14.5]). Ninety (84.1%) had CKD with 20.6% in end-stage renal disease (eGFR < 15 ml/min/1.73m2). Polyarticular involvement and tophi were commoner among patients with CKD (21.1% versus 11.8% p = 0.652 and χ = 4.364, p = 0.022 respectively) Serum uric acid levels positively correlated with serum creatinine (p = 0.006) and negatively correlated with eGFR (p = 0.001). The best predictor of SUA level was the eGFR (B =  − 2.598, p < 0.001).

Conclusion

Gout in north-eastern Nigeria constitutes about 11% of all rheumatic diseases and is typically monoarticular; however, polyarticular form and tophi were commonly seen in patients with CKD. Further studies will be needed to evaluate the relationship between the pattern of gout and CKD in the region.

Key Points

• Gout in Maiduguri is commonly monoarticular; however, polyarticular presentations and tophi are commoner among gout patients with chronic kidney disease (CKD).

• The increase in the burden of CKD might have resulted in the increase in the number of females with gout.

• The use of the validated and simple Netherlands criteria for the diagnosis of gout is useful in developing countries to overcome the challenges associated with the use of polarized microscope and thereby allowing further research on gout.

• There is a need for further research on the pattern and prevalence of gout and its relationship with CKD in Maiduguri, Nigeria.

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Acknowledgements

We acknowledged Hafiz Umar and Usman Hassan Usman for assisting in the extraction of case files and data.

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Authors and Affiliations

  1. Department of Internal Medicine, Rheumatology Unit, University of Maiduguri, Maiduguri, PMB 1069, Borno State, Nigeria

    Abubakar Yerima

  2. Department of Internal Medicine, Renal Unit, University of Maiduguri, Maiduguri, PMB 1069, Borno State, Nigeria

    Mohammad Maina Sulaiman

  3. Department of Internal Medicine, University of Maiduguri Teaching Hospital, Maiduguri, PMB 1414, Borno State, Nigeria

    Adamu Abba Adamu

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Yerima, A., Sulaiman, M.M. & Adamu, A.A. Pattern of gout and its association with chronic kidney disease in Maiduguri, northeastern Nigeria. Clin Rheumatol 42, 1775–1782 (2023). https://doi.org/10.1007/s10067-023-06572-1

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