Objective: To test whether renal impairment protects from the development of gout.
Methods: 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.
Results: 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).
Conclusion: 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.