Assessment of renal function in patients with gout in acute coronary syndrome
Objective. Dynamic assessment of renal function in patients with gout and acute coronary syndrome (ACS). Materials and methods. Data from the medical records of patients with ACS treated at the St. Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze from 2020 to 2024 were analyzed. Two groups of patients were identified: Group 1 – 94 patients with ACS and a concomitant diagnosis of gout; Group 2 (control) – 95 patients with ACS but no gout. The groups were matched by gender, age, and type of ACS. All patients had their serum creatinine measured and their glomerular filtration rate (GFR) calculated using the CKD-EPI formula upon hospital admission, on days 2–3, and after 7 days of hospitalization. Acute kidney injury (AKI) and its stages were determined according to KDIGO guidelines. The results were statistically processed. Results. Patients were divided into subgroups by chronic kidney disease (CKD) stage based on their baseline eGFR values. Stage III–IV CKD was observed in 35 (37.2%) patients in the gout+ACS group, compared to 13 (13.7%) in the control group, p<0.05. The incidence of AKI among patients with ACS and gout and in the control group was 23 (24.5%) and 8 (8.4%), respectively (p<0.05). In Group 1, the incidence of AKI increased with decreasing eGFR levels on admission. The mean age of patients who developed AKI was statistically significantly higher, and the initial eGFR level was lower than in patients without AKI (p<0.05). In patients who developed AKI in Group 1, non-ST-elevation ACS was the most common – 17 (73.9%); in patients with AKI without gout, ST-elevation ACS was the most common – 5 (62.5%), p<0.05. Fatal outcomes occurred in 9 (9.6%) patients in Group 1 and 4 (4.2%) patients in Group 2 (p>0.05). Among patients with AKI, there were 7 (30.4%) fatal outcomes in Group 1 and 2 (25.0%) in Group 2 (p>0.05). Conclusion. Patients with gout are more susceptible to developing AKI in ACS due to their underlying renal dysfunction (gouty nephropathy). This determines a more unfavorable prognosis in these patients.Shchemeleva E.V., Skorodumova E.A., Povzun A.S.
Keywords
acute kidney injury
gout
acute coronary syndrome
About the Authors
Elena V. Shchemeleva – Cand.Sci. (Med.), Researcher, Department of Emergency Cardiology and Rheumatology, St. Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze. Address: 3 Budapeshtskaya St., St. Petersburg; Tel.: +7 (921) 928-87-38; e-mail: schemeleva@yandex.ru. ORCID: 0000-0003-3566-6761.Elena A. Skorodumova – Dr.Sci. (Med.), Leading Researcher, Department of Emergency Cardiology and Rheumatology, St. Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze. Address: 3 Budapeshtskaya St., St. Petersburg; Tel.: +7 (921) 327-65-10; e-mail: elskor@mail.ru. ORCID: 0000-0002-5017-0214.
Anton S. Povzun – Cand.Sci. (Med.), Senior Researcher, Department of Emergency Cardiology and Rheumatology, St. Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze. Address: 3 Budapeshtskaya St., St. Petersburg; Tel.: +7 (911) 241-37-79; e-mail: a.s.povzun@gmail.com. ORCID: 0000-0002-9971-3507.
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