KIDNEY dysfunction is driving a rising global gout burden, with older men facing the greatest disability.
The global burden of gout attributable to kidney dysfunction increased over three decades, highlighting the need for more targeted screening and management strategies in high-risk populations. Using Global Burden of Disease 2021 data, investigators quantified gout related disability associated with renal impairment and assessed trends by age, sex, geography, and sociodemographic development.
Globally, gout attributable to renal impairment accounted for an estimated 200,033 disability adjusted life years (DALYs), with a 95% uncertainty interval of 125,245 to 296,812. The age standardized DALY rate rose from 1.47 per 100,000 population in 1990 to 2.36 per 100,000 population in 2021, corresponding to an estimated annual percentage change of 0.67.
Disparities Persist Across Regions and Sex
The burden was not evenly distributed. Higher sociodemographic index regions carried a disproportionate share of gout related disability attributable to kidney dysfunction, and the gap between high and low SDI regions continued to widen over time. The findings suggest that non genetic determinants, including healthcare access, diagnostic practices, environmental exposures, and dietary patterns, may play a meaningful role in shaping the global distribution of disease.
Sex based differences were also evident. Males had higher age standardized DALY rates than females, while both sexes showed progressive increases in burden with advancing age. This age dependent pattern is clinically important because older adults with renal impairment often have multiple comorbidities, complicating gout diagnosis, monitoring, and treatment selection.
Projections Suggest Future Decline
Despite the increase observed from 1990 to 2021, projection models indicated that the future global burden of gout attributable to kidney dysfunction may decline by 2036. The study used a Bayesian age period cohort model to forecast disease burden, while health inequality analyses assessed absolute and relative disparities across SDI regions.
The findings reinforce the need for tailored management in older adults, particularly men with renal impairment. Enhanced screening, optimized treatment strategies, and attention to regional inequities may help reduce disability from gout linked to kidney dysfunction.
Reference
Du K et al. The rising global burden of gout attributable to kidney dysfunction: a 30-year trend analysis and projections to 2036. Clin Rheumatol. 2026;doi:10.1007/s10067-026-08180-1.
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