Background Patients receiving kidney transplants are at increased risk for the development of hyperuricemia and gout compared to the general population, which is generally attributed to the frequent use of calcineurin inhibitors (cyclosporine and tacrolimus). However, the precise proportion of renal transplant patients that develop gout and the time period post-transplant in which this occurs is less established.
Objectives To analyze a large, mixed-insurance, US population database to determine gout prevalence in the renal transplant population.
Methods A retrospective review of Humana Healthcare claims data (private and Medicare) from 2007 to 2017 was undertaken to identify kidney transplant patients with at least 6 months in plan prior to transplant and at least 6 months in plan post-transplant. Diagnosis of gout (≥1 gout ICD 10/ICD 9 code) was evaluated in relationship to the time of kidney transplant.
Results The database contained 6,082 patients with a kidney transplant and at least 6 months in plan both pre and post-transplant. Of the 6,082 kidney transplant patients, 1,505 (25%) had a gout diagnosis: 908 (15% of transplant patients) with gout before and after transplant and 597 (10% of transplant patients) with a gout code only after transplant. In patients developing gout post-transplant, the mean time between transplant and gout diagnosis was 1.79 ± 1.85 years.
Conclusion As expected, gout was a common comorbidity in renal transplant patients. 15% of the patients receiving renal transplants had gout prior to the transplant, and another 10% developed new-onset gout a mean of 1.79 years after receiving a renal transplant. This retrospective analysis demonstrates that kidney transplant patients commonly suffer from gout both before and after their transplant. In addition to more research on this topic, an increased focus on screening and treatment of gout in the renal transplant population may be warranted.
References  Abbott K.C., Kimmel P.L., Dharnidharka V., et al. Transplantation. 2005; 80:1383-1391
 Zhu Y., Pandya B.J., Choi H.K. Arthritis & Rheumatism. 2011; 63(10):3136-3141
Disclosure of Interests Brian LaMoreaux Shareholder of: Horizon Pharma, Employee of: Horizon Pharma, Megan Francis-Sedlak Shareholder of: Horizon Pharma, Employee of: Horizon Pharma, Robert J Holt Shareholder of: Horizon Pharma, Employee of: Horizon Pharma
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