Analysis of Risk Factors for Changes in the Renal Two-Dimensional Image in Gout Patients

Figures & data

Figure 1 CONSORT flow diagram.

Abbreviation: ACR/EULAR, American Academy of Rheumatology/European Anti-Rheumatism Alliance.

Figure 2 Ultrasound examination of the kidney in a patient with gout. (A) The largest coronal surface of the kidney in the patient’s lateral position shows that the right renal medulla of the patient with gout has increased echo (indicated by the yellow arrow). (B) The largest coronal view of the kidney from a patient in lateral decubulation, showing a pyramidal stone in a patient with gout (indicated by the yellow arrow). (C) Maximum coronal view of ultrasonography kidney image of a normal patient in lateral decubitus position.

Table 1 Analysis of Clinical Characteristics and Ultrasonic Indicators of Patients with Gout

	n	x±s
Male/Female	219/8
Age (year)	227	46.352±14.94
Disease duration (year)	227	5.013±5.685
Height (cm)	227	167.41±6.662
Weight (kg)	227	73.419±12.432
BMI (kg/m^2)	227	26.156±3.716
Kidney volume (cm^3)	227	236.616±59.418
Renal cortex thickness (cm)	221	0.812±0.129
Renal parenchyma (cm)	227	1.794±0.260
The medulla of the kidney echoes	227	1.322±0.408
Number of kidney stones	227	1.648±1.879

Abbreviation: BMI, body mass index.

Table 2 Correlation Analysis of SUA and Ultrasonic Indexes with Laboratory Indexes

	SUA (μmol/L)		Kidney Volume (cm^3)		Renal Cortex Thickness (cm)		Renal Parenchyma (cm)		The Medulla of the Kidney Echoes		Kidney Stones
	r	P	r	P	r	P	r	P	r	P	r	P
Disease duration (year)	0.122	0.07	−0.227	0.001	−0.213	0.001	−0.179	0.007	0.28	<0.001	0.141	0.033
Height (cm)	0.168	0.012	0.315	<0.001	0.174	0.009	0.199	0.003	−0.219	0.001	−0.184	0.006
Weight (kg)	0.076	0.262	0.629	<0.001	0.242	<0.001	0.323	<0.001	−0.158	0.017	−0.324	<0.001
BMI (kg/m2)	0.018	0.788	0.562	<0.001	0.211	0.002	0.275	<0.001	−0.079	0.236	−0.25	<0.001
RBC (10^12/L)	0.073	0.28	0.349	<0.001	0.282	<0.001	0.279	<0.001	−0.203	0.003	−0.113	0.095
HGB (g/L)	0.116	0.089	0.267	<0.001	0.276	<0.001	0.290	<0.001	−0.190	0.005	−0.145	0.033
PLT (10^9/L)	−0.05	0.464	0.321	<0.001	0.11	0.108	0.153	0.023	−0.046	0.496	−0.048	0.481
NE (%)	−0.081	0.234	−0.113	0.094	−0.151	0.028	−0.227	0.001	0.087	0.199	0.113	0.096
LY (%)	0.082	0.23	0.12	0.076	0.183	0.007	0.219	0.001	−0.074	0.273	−0.126	0.062
ALT (U/L)	0.147	0.029	0.222	0.001	0.148	0.031	0.187	0.005	−0.147	0.029	−0.139	0.04
GGT (U/L)	0.103	0.132	0.320	<0.001	0.135	0.052	0.137	0.044	−0.242	<0.001	−0.199	0.003
UREA (mmol/L)	0.143	0.034	−0.173	0.01	−0.227	0.001	−0.176	0.009	0.228	0.001	0.161	0.017
CREA (μmol/L)	0.197	0.003	−0.308	<0.001	−0.317	<0.001	−0.360	<0.001	0.207	0.002	0.144	0.133
eGFR (mL/min)	0.259	<0.001	−0.176	0.009	−0.168	0.014	−0.180	0.008	0.112	0.096	0.032	0.633
CysC (mg/L)	0.175	0.01	−0.257	<0.001	−0.391	<0.001	−0.361	<0.001	0.255	<0.001	0.073	0.283
Hcy (μmol/L)	0.13	0.073	−0.132	0.069	−0.210	0.004	−0.174	0.016	0.071	0.328	0.086	0.237
β2-MG (mg/L)	0.146	0.032	−0.365	<0.001	−0.382	<0.001	−0.389	<0.001	0.247	<0.001	0.098	0.15
TP (g/L)	0.155	0.022	0.137	0.043	0.138	0.044	0.109	0.107	−0.117	0.084	−0.037	0.591
ALB (g/L)	0.152	0.025	0.128	0.058	0.243	<0.001	0.265	<0.001	−0.166	0.014	−0.043	0.531
A:G	0.076	0.262	0.049	0.474	0.216	0.001	0.226	0.001	−0.128	0.058	−0.062	0.363
TG (mmol/L)	0.240	0.001	0.206	0.004	0.025	0.734	0.02	0.777	−0.132	0.063	−0.076	0.285
HDLC (mmol/L)	−0.018	0.805	−0.149	0.036	0.057	0.428	−0.082	0.25	0.032	0.655	0.142	0.046
LDLC (mmol/L)	0.061	0.394	0.141	0.047	0.056	0.437	0.068	0.34	−0.06	0.405	0.033	0.649
Lp(a) mg/L	−0.092	0.205	−0.075	0.304	−0.037	0.618	−0.085	0.241	0.141	0.053	0.200	0.006
ApoA-I/ApoB	−0.008	0.906	−0.145	0.043	−0.032	0.663	−0.01	0.891	−0.002	0.977	−0.054	0.448
ESR (mm/h)	−0.129	0.07	−0.159	0.025	−0.198	0.006	−0.258	<0.001	0.221	0.002	0.13	0.068
UUA (umol/L)	0.124	0.08	0.278	<0.001	0.036	0.613	0.13	0.063	−0.140	0.046	−0.08	0.257
PH	−0.244	<0.001	−0.002	0.979	0	0.995	0.065	0.345	−0.099	0.155	−0.251	<0.001
FPG (mmol/L)	−0.221	0.003	−0.048	0.521	0.031	0.683	−0.014	0.847	−0.052	0.486	−0.023	0.76

Note: P < 0.05: statistically significant.

Abbreviations: SUA, serum uric acid; BMI, body mass index; RBC, red blood cell; HGB, hemoglobin; PLT, platelet; NE%, neutrophils percentage; LY%, lymphocytes percentage; BA, basophil; ALT, alanine aminotransferase; GGT, gamma-glutamyl transpeptidase; UREA, urea; CREA, creatinine; eGFR, estimated glomerular filtration rate; CysC, cystatin C; Hcy, homocysteine; β2-MG, β2-microglobulin; TP, total protein; ALB, albumin; A:G, albumin/globulin ratio; TG, triglycerides; HDLC, high-density lipoprotein cholesterol; LDLC, low-density lipoprotein cholesterol; Lp(a), lipoprotein(a); ApoA-I/ApoB, apolipoprotein A-I/apolipoprotein B ratio; ESR, erythrocyte sedimentation rate; UUA, urine uric acid; FPG, fasting plasma glucose.

Figure 3 Logistic regression analysis of renal ultrasound parameters and laboratory indexes in patients with gout. P < 0.05: statistically significant. (A) Risk factors for renal cortical thickness, showing that disease duration, AST, CREA and tophi were risk factors of renal cortical thinning in patients with gout. [OR (95% CI) were respectively 0.872 (0.762, 0.997), 0.911 (0.84, 0.989), 0.345 (0.167, 0.713), 0.12 (0.026, 0.551)]. (B and C) Risk factors for renal medulla echo, showing that CRP and CysC are risk factors of renal hyperechogenicity of renal medulla in patients with gout [OR (95% CI) were respectively 1.029 (1.003, 1.055), 234.172 (2.218, 24725.903)].PH and GGT are protective factors of renal hyperechogenicity of renal medulla in patients with gout [OR (95% CI) were respectively 0.259 (0.096, 0.702), 0.969 (0.952, 0.986)], Among them, GGT protection factor is weak. (D and E) Risk factors for the presence of renal stones, showing that disease duration, PLT and HDL-C are the risk factors for gout patients with nephrolithiasis [OR (95% CI) were respectively 1.192 (1.01, 1.406), 1.014 (1.002, 1.027), 230.115 (2.116, 25024.194)], PH and GGT are protective factors of kidney stone formation in patients with gout [OR (95% CI) were respectively 0.185 (0.06, 0.574), 0.964 (0.946, 0.983)], Among them, GGT protection factor is weak.

Abbreviations: CREA, creatinine; AST, aspartate transaminase; GGT, gamma-glutamyl transpeptidase; CRP, C reactive protein; CysC, cystatin C; PLT, platelet; HDL-C, high-density lipoprotein cholesterol.