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Purpose: Dehydration is thought to be one possible trigger for acute gout attacks. We therefore examined whether water consumption may reduce the risk for recurrent gout attacks.
Methods: We conducted an internet-based case-crossover study to assess a set of putative risk factors thought to trigger recurrent gout attacks. This methodology uses each participant as his/her own control by comparing the frequency of a particular risk factor during periods of gout attacks with that during periods during which they are not having an attack, thereby eliminating between-person confounding. Subjects with gout who had an attack within the past year were recruited online and asked to provide access to medical records pertaining to their gout diagnosis. Data were obtained on the amount of water consumed over the 24-hour period before a gout attack and over the 24-hour period during an intercritical period. We examined the relation of amount of water intake (0-1, 2-4, 5-8, >8 glasses per 24-hours) and the risk of recurrent gout attacks using conditional logistic regression adjusting for diuretic use, alcohol consumption, and purine intake.
Results: 535 participants (78% male, mean age 53) provided information during both times of a gout attack and an intercritical period (median # of attacks/person=2; median # of intercritical period questionnaires/person=2). Increasing water intake was associated with decreased risk for recurrent gout attacks (Table).
Conclusions: Water
intake in the prior 24-hours was associated with a significant reduction in
risk for recurrent gout attacks. Drinking adequate water may be a simple, safe,
and effective way for individuals with gout to prevent recurrent gout attacks,
and can easily be recommended to patients with gout by healthcare providers.
Future work will examine the effects of other concurrent beverage intake.
Table: Relation of water intake in prior 24-hours to risk for recurrent gout attack | ||||
Amount of water intake in prior 24-hours | N case periods | N control periods | Crude OR | *Adjusted OR (95% CI) |
0-1 glass | 163 | 159 | 1.0 (ref) | 1.0 (ref) |
2-4 glasses | 487 | 579 | 0.82 | 0.84 (0.59-1.18) |
5-8 glasses | 356 | 441 | 0.57 | 0.60 (0.40-0.90) |
>8 glasses | 116 | 138 | 0.52 | 0.54 (0.32-0.90) |
P for linear trend |
|
|
| P=0.02 |
*adjusted for diuretic use, purine and alcohol intake | ||||