scholarly journals HUBUNGAN POLA MAKAN DAN TINGKAT PENGETAHUAN DENGAN KADAR ASAM URAT DALAM DARAH PADA PENDERITA GOUT ARTRITIS DI PUSKESMAS RANOTANA WERU

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Anisha M.G Songgigilan ◽  
Inneke Rumengan ◽  
Rina Kundre
Keyword(s):  
Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Sampling Technique ◽  
The Body ◽  
Chi Square ◽  
Cross Sectional ◽  
Eating Pattern ◽  
Purposive Sampling ◽  
Level Of Significance

Abstrack: Gout Arthritis is one of degenerative diseases that attacks joint marked by the increasing of uric acid level excessively inside the body, and when it is repeating chronically, it may cause thopi. The lack of society's knowledge about gout arthritis may lead to the emergence of this disease, where it also happens because of the eating pattern. Eating Pattern consists of the frequency of food, types of food, the purpose, eat, the function of food, and the way how was the food processed. The aim of this study is to know the relation between eating pattern & knowledge extent of uric acid level of people with gout arthritis in public health center of ranotana weru’s. Research method is using the cross sectional approach. The study involved 93 gout arthritis sufferers as the respondents by using purposive sampling technique. Data collected by using questionnaires. The result is using chi square in the level of significance 95% which values that significant value 0,000 < 0,05 for eating pattern and 0,001 < 0,05 Conclusion, there is a relation between eating pattern and uric acid level, and there is a relation between knowledge extent and uric acid level.Keywords : Uric acid level, knowledge level, eating patternAbstrak : Gout artritis merupakan salah satu penyakit degenerative yang menyerang sistem persendian dimana penyakit ini ditandai dengan peningkatan kadar asam urat dalam tubuh secara berlebihan dan gout artritis yang terjadi berulang atau bertahun akan menyebabkan timbulnya tophi. Kurangnya pengetahuan masyarakat tentang gout artritis bepengaruh terhadap terjadinya gout artritis, dimana salah satu faktor penyebab terjadinya gout artritis yaitu pola makan. Pola makan terdiri dari frekuensi makanan, jenis makanan, tujuan, makan, fungsi makanan, dan cara pengolahan makanan. Tujuan penelitian ini adalah mengetahui hubungan pola makan dan tingkat pengetahuan dengan kadar asam urat dalam darah pada penderita gout artritis di puskesmas ranotana weru. Metode penelitian menggunakan pendekatan cross sectional. Responden terdiri dari 93 penderita gout artritis dengan teknik pengambilan sampel dengan cara purposive sampling. Pengumpulan data menggunakan kuesioner. Hasil Uji penelitian dengan menggunakan uji chi-square pada tingkat kemaknaan 95%, didapat bahwa nilai signifikan 0,000 < 0,05 untuk pola makan dan 0,001 < 0,05. Kesimpulan terdapat hubungan antara pola makan dengan kadar asam urat dalam darah dan terdapat hubungan antara tingkat pengetahuan dengan kadar asam urat dalam.Kata kunci : Kadar asam urat, tingkat pengetahuan, pola makan

scholarly journals POLA KONSUMSI SUMBER PURIN, AKTIVITAS FISIK DAN STATUS GIZI DENGAN KADAR ASAM URAT PADA LANSIA DI PUSKESMAS KECAMATAN MAKASAR JAKARTA

2020 ◽  
Vol 4 (1) ◽  
pp. 84
Author(s):  
Gina Ganda Fitriana ◽  
Adhila Fayasari
Keyword(s):  
Physical Activity ◽  
Uric Acid ◽  
Nutritional Status ◽  
Uric Acid Level ◽  
Acid Level ◽  
Consumption Pattern ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Significant Difference

Degenerative processes can decrease the endurance in elderly that leads to health problem such as gout. Gout is a metabolic disorder, which is indicated by an increase uric acid in bloodstream (hyperuricemia). Factors affecting high level of uric acid are purine intake, physical activity and nutritional status. The aim of this study was to analyze the relationship between consumption pattern of purine source food, nutritional status and physical activity with uric acid level in elderly. The study design was cross sectional. The sample consisted of 100 subyekts at Puskesmas Kecamatan Makasar. The analytical used chi square. Patterns of food consumption of purine sources were measured using FFQ questionnaires which was then cut off into into 2 categories: low-moderate purine category with score <55 and high purine category with a score of ≥55 physical activity and nutritional status were measured using questionnaires, uric acid levels was obtained by looking at laboratory results or from patients' medical records. There was 10% of subyekts withlo- moderate uric acid levels and 90% of subyekts with high purine consumption pattern. Based on the results of chi square test there was a significant difference (p <0.05) between the consumption pattern of purine source food with normal uric acid and high uric acid. There was a relationship between consumption pattern of purine food source with uric acid level in elderly.

scholarly journals EFEKTIVITAS MEPASANGU (BAKERA) TERHADAP GANGGUAN KESEHATAN PADA MAHASISWA PROGRAM STUDI KEPERAWATAN POLITEKNIK NEGERI NUSA UTARA

2020 ◽  
Vol 4 (2) ◽  
pp. 74-80
Author(s):  
Christien Rambi ◽  
Ferdinand Gansalangi
Keyword(s):  
Sampling Technique ◽  
Health Problems ◽  
The Body ◽  
P Value ◽  
Inclusion Criteria ◽  
Chi Square ◽  
Study Program ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Chi Square Test

Indonesia memiliki 7.000 dari 30.000 jenis tumbuhan yang tumbuh di Indonesia yang dapat digunakan sebagai obat tradisional. Salah satu metode pengobatan tradisional yang terkenal di Kepulauan Sangihe ialah mepasangu yang diartikan sebagai kegiatan bakera (memanfaatkan uap hasil rebusan berbagai rempah). Kegiatan ini dijadikan tradisi untuk terapi bagi seorang wanita setelah melahirkan dan juga bagi seseorang yang mengalami gangguan kesehatan akibat masuk angin, berupa keluhan pegal di seluruh badan. Tujuan penelitian ini ialah diketahuinya efektifitas mepasangu terhadap gangguan kesehatan pada mahasiswa. Metode yang digunakan ialah desain penelitian cross sectional. Seluruh mahasiswa semester 1, 3, dan 5 Program Studi Keperawatan dijadikan populasi dalam penelitian ini, sedangkan teknik pengambilan sampel ialah purposive sampling berdasarkan pertimbangan beberapa kriteria dengan jumlah sampel sebanyak 46 orang. Penelitian ini dilaksanakan mulai bulan Juli sampai Oktober 2020. Instrumen penelitian yang digunakan ialah tanaman rempah, seperti buah cengkeh dan daunnya, buah pala dan daunnya, sereh, daun puring, dan daun pandan. Keluhan gangguan kesehatan responden dicatat pada lembar observasi. Analisa data menggunakan uji chi square. Hasil penelitian menunjukkan bahwa 60,8 % responden mengalami keluhan gangguan kesehatan insomnia dan masuk angin yang terjadi bersamaan dan keluhan yang paling sedikit ialah hanya keluhan masuk angin pada responden, yaitu sebanyak 3 orang (6.5%). Berdasarkan hasil analisis statistik menggunakan uji chi square diperoleh nilai p = 0,025 dimana nilai p < 0,05, sehingga dapat disimpulkan bahwa mepasangu efektif mengatasi gangguan kesehatan. Mepasangu dapat digunakan sebagai terapi tradisional dalam mengatasi gangguan kesehatan berupa insomnia, masuk angin, dan badan pegal.   Indonesia has 7,000 of the 30,000 type of plants that grow in Indonesia that used as traditional medicine. One of the well-known traditional healing method in the Sangihe Island is Mepasangu, which is defined as Bakera activity (utilizing steam from the stew of various spices). This activity was used as a tradition for the treatment of a woman after giving birth and also for someone who experiences health problems due to cold, in the form of complaints of stiffness all over the body. The purpose of this study was determine the effectiveness of mepasangu against health problems in students. The method used in this study was a cross sectional research design. All students in semester 1, 3, and 5 of the Nursing Study Program were the population in this study, while the sampling technique was purposive sampling based on the consideration of several criteria. The number of samples that met the inclusion criteria was 46 people. This research was conducted from July to October 2020. The research instrument used were several spices, such as cloves and their leaves, nutmeg and leaves, lemongrass, croton leaves, and pandan leaves. Complaints about the respondent's health problems were recorded on the observation sheet. Anlyze data used the chi square test as a statistical test. The results showed that 60.8% of respondents experienced complaints of health problems, insomnia and cold that occurred simultaneously and the least complaints were only complaints of colds among respondents, as many as 3 people (6.5%). Based on the results of statistical analysis used the chi square test, the value of p = 0.025 was obtained where the p value <0.05, so it can be concluded that mepasangu was effective in overcoming health problems. Mepasangu can be used as a traditional therapy to treat health problems such as insomnia, cold and body aches.

scholarly journals Correlation nutritional status with uric acid level in Minangkabau men ethnicity

2018 ◽  
Vol 7 (1) ◽  
pp. 131
Author(s):  
Desmawati Desmawati ◽  
Yuniar Lestari ◽  
Ulya Uti Fasrini ◽  
Delmi Sulastri
Keyword(s):  
Uric Acid ◽  
Nutritional Status ◽  
Serum Uric Acid ◽  
Uric Acid Level ◽  
Significant Relationship ◽  
Acid Level ◽  
Laboratory Data ◽  
Overweight And Obesity ◽  
Chi Square ◽  
Cross Sectional

Background: Hyperuricemia is a predictor of metabolic syndrome influenced by many factors, one of which is nutritional status. A highly prevalence overweight and obesity in ethnic Minangkabau is quite high which can increase the prevalence of hyperuricemia. This study aims to determine the relationship of nutritional status intake with Minangkabau ethnic male uric acid levels.Methods: This study used a cross-sectional design, done in August to November 2016. Nutritional status was obtained through the measurement of body mass index (BMI) based on height and weight. The uric acid level examined in the Prodia laboratory. Data were analyzed by using chi-square test.Results: Most of subject were obesities. A total of 21% subjects suffers hyperuricemia. Statistic test results showed that there was a significant relationship between nutritional status and serum uric acid levels (p <0.0001).Conclusions: There was a significant relationship between nutritional status and serum uric acid levels in Minangkabau ethnic men in Padang city.

scholarly journals Prevalence of Albuminuria and Associated Factors among Gout Arthritis Patients in Cipto Mangunkusumo Hospital

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Jeffrey Christian Mahardhika ◽  
R.M. Suryo Anggoro
Keyword(s):  
Body Mass Index ◽  
Uric Acid ◽  
Body Mass ◽  
Uric Acid Level ◽  
Associated Factors ◽  
Acid Level ◽  
Kidney Diseases ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional

Background Gout arthritis associates with many comorbodities such as hyperuricemia, hypertension, hyperglycemia, obesity, and dyslipidemia, which are also factors for the development of/or predisposition factors of chronic kidney diseases (CKD). Albuminuria is a predictor factors for CKD. Screening for albuminuria is needed to be done in patients with high risk of CKD. This research was conducted to examine the prevalence of albuminuria and the associated factors in gout arthritis patients.Methods This research was a cross-sectional study from gout arthritis patients’ medical records in Cipto Mangunkusumo Hospital. We included all gout patients who treated within 2011−2015. Subjects with chronic kidney disease, in kidney replacement therapy, hypertension ≥ 10 years, and diabetes ≥ 5 years were excluded. Albuminuria was determined by urine dipstick result of protein ≥ 1+. Factors associated were age, sex, hyperuricemia, hypertension, stage of hypertension, hyperglycemia, obesity, dyslipidemia, uric acid level, and body mass index (BMI). Data associated with the factors were recorded and the associations were tested with chi square, fisher’s exact, or independent t-test.Results from 54 subjects included in this research, the prevalence of albuminuria was 20.4%. There were no significant associations between all factors and albuminuria tested by chi square and fisher’s exact test. Independent t-test’s results also showed no significant associations between all the factors and albuminuriaConclusion The prevalence of albuminuria in gout arthritis patient was 20.4%. There were no significant associatons between age, sex, hyperuricemia, hypertension, hyperglycemia, obesity, dyslipidemia, uric acid level, and body mass index (BMI) tested with albuminuria in gout arthritis patients in Cipto Mangunkusumo Hospital from 2011−2015.Keywords: Prevalence, Albuminuria, Gout Arthritis, Risk Factors

scholarly journals PERBANDINGAN KADAR ASAM URAT PADA SUBYEK OBES DAN NON-OBES DI FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI MANADO

e-CliniC ◽  
2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Elim Rau ◽  
Jeffrey Ongkowijaya ◽  
Ventje Kawengian
Keyword(s):  
Uric Acid ◽  
Body Fat ◽  
Uric Acid Level ◽  
Acid Level ◽  
Serum Uric Acid Level ◽  
Normal Serum ◽  
The Body ◽  
Obese Group ◽  
Male Students ◽  
Cross Sectional

Abstract: Uric acid is the end product of purine metabolism. Circulating uric acid in the human body is produced by the body (endogenous uric acid) as well as derived from food (exogenous uric acid). Normal serum uric acid level is <7.0 mg / dL in men and <6.0 in women. Obesity can be defined as excess body fat. One of the markers used for body fat content is body mass index (BMI). This study aimed to compare the levels of uric acid in obese and non-obese subjects. This was an analytical study with a cross sectional design. The population is students of Faculty of Medicine University of Sam Ratulangi Manado. Samples were male students of batch 2013. There were 42 male students, consisted of 21 obese and 21 non-obese students. The results showed that the average of uric acid levels in obese group was 8.05 mg/dL and in non-obese group 6.63 mg/dL. In the obese group, 67% had an increase in uric acid level meanwhile in the non-obese group only 38%. The statistical test showed a sig 0,009. Conclusion: In this study, the average of uric acid level in obese group was significantly higher than in the non-obese group. However, there were students with either normal or high uric acid levels in both groups.Keywords: uric acid, obeseAbstrak: Asam urat merupakan produk akhir metabolisme purin. Asam urat yang beredar di dalam tubuh manusia di produksi sendiri oleh tubuh (asam urat endogen) dan berasal dari makanan (asam urat eksogen). Normalnya kadar asam urat serum <7,0 mg/dL pada pria dan <6,0 mg/dL pada wanita. Obesitas dapat di definisikan sebagai kelebihan lemak tubuh. Penanda kandungan lemak tubuh yang digunakan ialah indeks masa tubuh (IMT). Penelitian ini bertujuan untuk mengetahui perbandingan kadar asam urat pada subyek obes dan non obes. Penelitian ini bersifat analitik dengan pendekatan potong lintang. Populasi penelitian ialah mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Manado. Sampel idalah mahasiswa pria angkatan 2013 dan didapatkan 42 orang yang terbagi atas 21 obes dan 21 non obes. Hasil penelitian memperlihatkan rerata kadar asam urat pada obes 8,05 mg/dL dan pada non-obes 6,63 mg/dL. Peningkatan kadar asam urat ditemukan 67% pada kelompok obes dan 38% pada kelompok non-obes. Uji statistik menunjukkan nilai sig 0,009. Simpulan: Pada penelitian ini rerata kadar asam urat pada kelompok obes lebih tinggi secara bermakna daripada kelompok non-obes. Walaupun demikian, pada kedua kelompok ditemukan mahasiswa dengan kadar asam urat normal maupun meningkat.Kata kunci: asam urat, obesitas

scholarly journals EATING PATTERN CONTAINS EXCESSIVE PURIN SUBSTANCE IMPROVING GOUT ARTHRITIS PREVALENCE IN COMMUNITIES IN KOTABUNAN VILLAGE

2018 ◽  
Vol 6 (2) ◽  
pp. 59-67
Author(s):  
Rizky Nurul Fauziah ◽  
Herlina P Memah ◽  
Lorrien G Runtu
Keyword(s):  
Uric Acid ◽  
Correlation Method ◽  
Sampling Technique ◽  
Total Sample ◽  
Chi Square ◽  
Cross Sectional ◽  
Eating Pattern ◽  
Significance Level ◽  
Long Time ◽  
X 24

Background: Gout Arthritis is an inflammatory disease in the joints that causes extreme pain, swelling, sometimes redness and is difficult to move and if it lasts for a long time it can cause deformity in the affected joint. Objective: To determine the relationship between diet and gout arthritis. The design used is correlation. Method: This type of research is analytic descriptive research with cross-sectional approach. the location of the study was in Kotabunan Village, Kotabunan Subdistrict, Bolaang Mongondow Timur Regency from July 21 to July 23, 2018. The sampling technique used a total sample with 49 respondents. The instrument uses a food recall questionnaire 2 x 24 hours. Results: Statistical test with chi-square with significance level (α) 0.05. Correlation test results obtained ρ = 0.002. The conclusion : This study is that there is a relationship between diet and the incidence of gout arthritis, where the more often the consumption of high purine content, the higher the value of uric acid levels. Suggestion: People can maintain their diet well considering there are still many people who do not maintain their diet so that it results in increased levels of uric acid in the blood.

scholarly journals Prevalence of Albuminuria and Associated Factors among Gout Arthritis Patients in Cipto Mangunkusumo Hospital

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Jeffrey Christian Mahardhika ◽  
R.M. Suryo Anggoro
Keyword(s):  
Body Mass Index ◽  
Uric Acid ◽  
Body Mass ◽  
Uric Acid Level ◽  
Associated Factors ◽  
Acid Level ◽  
Kidney Diseases ◽  
Protein A ◽  
Chi Square ◽  
Cross Sectional

Background Gout arthritis associates with many comorbodities such as hyperuricemia, hypertension, hyperglycemia, obesity, and dyslipidemia, which are also factors for the development of/or predisposition factors of chronic kidney diseases (CKD). Albuminuria is a predictor factors for CKD. Screening for albuminuria is needed to be done in patients with high risk of CKD. This research was conducted to examine the prevalence of albuminuria and the associated factors in gout arthritis patients.Methods This research was a cross-sectional study from gout arthritis patients’ medical records in Cipto Mangunkusumo Hospital. We included all gout patients who treated within 2011−2015. Subjects with chronic kidney disease, in kidney replacement therapy, hypertension ≥ 10 years, and diabetes ≥ 5 years were excluded. Albuminuria was determined by urine dipstick result of protein ≥ 1+. Factors associated were age, sex, hyperuricemia, hypertension, stage of hypertension, hyperglycemia, obesity, dyslipidemia, uric acid level, and body mass index (BMI). Data associated with the factors were recorded and the associations were tested with chi square, fisher’s exact, or independent t-test.Results from 54 subjects included in this research, the prevalence of albuminuria was 20.4%. There were no significant associations between all factors and albuminuria tested by chi square and fisher’s exact test. Independent t-test’s results also showed no significant associations between all the factors and albuminuriaConclusion The prevalence of albuminuria in gout arthritis patient was 20.4%. There were no significant associatons between age, sex, hyperuricemia, hypertension, hyperglycemia, obesity, dyslipidemia, uric acid level, and body mass index (BMI) tested with albuminuria in gout arthritis patients in Cipto Mangunkusumo Hospital from 2011−2015.Keywords: Prevalence, Albuminuria, Gout Arthritis, Risk Factors

Hubungan Kadar Kolesterol Total Dan Hipertensi Dengan Kejadian Penyakit Jantung Koroner DI RSUD dr. Soedarso Pontianak

2018 ◽  
Vol 1 (2) ◽  
pp. 99
Author(s):  
Laila Kamila ◽  
Maulidiyah Salim
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Total Cholesterol ◽  
Blood Vessels ◽  
Public Hospital ◽  
Sampling Technique ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling

Abstract: Coronary heart is a disease that offense to blood vessels and heart attack due to constriction of blood vessels. A high level of cholesterol in blood or exceeds the normal limit can form sediment in wall of blodd vessels which cause blood vessels constriction or blockage. This research object to determine whether there is a correlation between cholesterol level total and hypertension with coronary heart disease in patients who hospitalized in Regional Public Hospital of dr. Soedarso Pontianak. This study was used cross sectional design, purposive sampling technique, it gained 50 people as samples. The measurement of blood pressure was done in heart poly and cholesterol total level in clinic laboratory of Regional Public Hospital of dr. Soedarso by using enzymatic CHOD-PAP method. It can be obtained that 10 people had hypertension and 40 people did not.the average of total cholesterol was 224 mg/dl. Maximum value of total cholesterol was 224 mg/dl and 152 mg/dl as minimum value. Data has been analyzed by using statistical test, Chi-Square, to determine the correlation of total cholesterol wit coronary heart disease, obtained p value=0,024 (less than α=0,05). Correlation of hypertension and coronary heart disease gained p value=0,923 (more than α=0,05), it can be concluded that total cholesterol correlated with coronary heart disease, and there was not a correlation between hypertension and coronary heart disease.Abstrak: Jantung koroner adalah penyakit yang  menyerang pembuluh darah dan serangan jantung, karena penyempitan pada pembuluh darah. Kadar kolesterol yang tinggi dalam darah melebihi normal dapat membentuk endapan pada dinding pembuluh darah sehingga menyebabkan penyempitan dan tersumbatnya pembuluh darah. Penelitian ini bertujuan untuk mengetahui hubungan kadar kolesterol total dan hipertensi dengan penyakit jantung koroner pada pasien di RSUD dr. Soedarso Pontianak. Disain penelitian  ini menggunakan cross sectional, teknik pengambilan sampel yaitu purposive sampling, didapat jumlah sampel 50 orang. Pengukuran Tensi Darah dilakukan di poli Jantung dan pemeriksaan kadar kolesterol total di laboratorium klinik RSUD dr. Soedarso Pontianak dengan metode enzimatik CHOD-PAP. Hasil penelitian didapatkan 10 orang mengalami hipertensi dan 40 orang non hipertensi. Rata-rata kadar kolesterol total 224 mg/ dl. Nilai maksimum kadar kolesterol total yaitu 224 mg/dl dan nilai minimum yaitu 152 mg/dl. Analisa data dengan uji statistik Chi-square untuk mengetahui hubungan kolesterol total dengan penyakit jantung koroner didapatkan nilai p = 0,024 (lebih kecil dari  α 0,05). Uji hubungan hipertensi dengan penyakit jantung koroner didapat nilai p = 0,923 (lebih besar dari α 0,05), dapat disimpulkan terdapat hubungan kadar kolesterol total dengan penyakit jantung koroner dan tidak ada hubungan hipertensi dengan penyakit jantung koroner.

HUBUNGAN KEPATUHAN DIET RENDAH PURIN DENGAN ASAM URAT DI PUSKESMAS WARA KOTA PALOPO TAHUN 2016

2018 ◽  
Vol 6 (08) ◽  
pp. 31-37
Author(s):  
Abdullah Sappe Ampin Maja
Keyword(s):  
Uric Acid ◽  
Sampling Technique ◽  
Statistical Test ◽  
Health Clinic ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Dietary Compliance ◽  
Exact Test ◽  
Purposive Sampling ◽  
Food Consumed

The research of this research to analysis dietary compliance of low purine diet in uric acid patients in Wara Health Clinic Year 2016. Type of this research that was used cross sectional approach and use a sampling technique was purposive sampling. The sample of the research was a portion of gout patients enrolled in Wara Health Clinic that fulfilled the inclusion criteria were 42 people.Based on the analysis by using statistical test Fisher's exact test, the value p = 0468 (p> 0.05%), it can be concluded that the hypothesis "there is no correlation between dietary compliance low purine with uric acid in Puskesmas Wara Palopo".Based on the result of research purpose recommendations were provide clearly information about the low purine diet and provide support in the form of motivation for pay attention of type food consumed so as to prevent the increasing of uric acid. Keywords : Compliance, Diet Low Purin, Uric Acid

scholarly journals AB0932 FACTORS IN ACHIEVING TARGET SERUM URIC ACID LEVELS IN OUTPATIENT GOUT MANAGEMENT IN A MALAYSIAN TERTIARY RHEUMATOLOGY CENTRE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1766.2-1766
Author(s):  
M. H. Mustapha ◽  
H. Baharuddin ◽  
N. Zainudin ◽  
S. S. Ch’ng ◽  
H. Mohd Yusoof ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Cross Sectional Study ◽  
British Society ◽  
Treat To Target ◽  
Tophaceous Gout ◽  
Cross Sectional ◽  
The Mean

Background:Gout is one of the most common inflammatory arthropathies. A target serum uric acid of less than 300µmol/l is recommended when tophi are present, and less than 360µmol/l for non-tophaceous gout. Urate-lowering therapy (ULT) should be titrated until the target is achieved and long-term maintenance of the target concentration is recommended. Although ULT has been proven to reduce the uric acid level, less than half of treated patients achieved the target serum uric acid (sUA) in real-world clinical practice.Objectives:To assess the mean treat-to-target achievement in outpatient management of gout by the tertiary rheumatology centre and to identify factors influencing the success rate.Methods:Retrospective cross-sectional study of all patients with gout attending out-patient clinics in a rheumatology referral centre from 1stJanuary 2018 until 31stDecember 2018. Electronic medical records were reviewed. The successful target achievement is defined as mean of all available sUA in 2018 which is ≤360 and ≤300µmol/l for non-tophaceous and tophaceous gout respectively. Chronic kidney disease (CKD) is defined as glomerular filtration rate of less than 60ml/min.Results:There were 251 patients analysed with mean age of 56.3±13.8 years and disease duration of 10.5±9.2 years. Majority were males (215, 85.7%) and 133 (53%) patients had tophaceous gout. The rate of success achieving the target SUA level of ≤360 and ≤300µmol/l were 33.9% (40) and 15.8% (21) in non-tophaceous and tophaceous gout respectively. However, in patients who are compliant, the target sUA achieved is 52.4% (33) and 31.7% (19) in non-tophaceous and tophaceous gout respectively. Characteristics of patients who achieved the targeted sUA were patients of more than 50 years old (48, 78.7%), without family history of gout (29, 65.9%), were prescribed colchicine prophylaxis upon initiating ULT (46, 76.7%), with absence of joint erosions (34, 73.9%) and those with normal creatinine clearance (40, 65.5%). There were 120 (48.4%) patients who were compliant to ULT. In 42 compliant patients who achieved target sUA, the mean allopurinol dose is 289.66mg±101.2 and 369.23mg±175 in non-tophaceous and tophaceous gout respectively. Sub-analysis in 31 compliant CKD patients, revealed no difference in allopurinol dose between those who achieved versus non-achieved target sUA (mean 243mg versus 263mg respectively). However, we noted that 11 (61%) CKD patients with tophi did not achieved target sUA at dose less than 300mg allopurinol. Lower achievement of target sUA was significantly associated with presence of tophi (p=0.001), poor compliance (p= 0.000) and presence of more than one comorbidity (p=0.041).Conclusion:There are several challenges in achieving target uric acid level contributed by both patient and clinician factors such as compliance, presence of comorbidity and ULT dose. Our study suggests that higher dosage of allopurinol is required in patients with tophaceous gout, with or without renal impairment. However, the limitation of this study is, the small number of subjects which therefore needsfurtherinvestigation.References:[1]Roddy, E., Packham, J., Obrenovic, K., Rivett, A., & Ledingham, J. M. (2018). Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology, 57(5), 826–830.[2]Katayama A, Yokokawa H, Fukuda H, et al. Achievement of Target Serum Uric Acid Levels and Factors Associated with Therapeutic Failure among Japanese Men Treated for Hyperuricemia/Gout. Intern Med. 2019;58(9):1225–1231.Disclosure of Interests:Mariam Hamid Mustapha: None declared, Hazlyna Baharuddin Speakers bureau: Sanofi, J&J, Norliza Zainudin: None declared, Shereen Suyin Ch’ng Speakers bureau: Novartis, Pfizer, GSK, Habibah Mohd Yusoof: None declared, Ing Soo Lau: None declared, Mollyza Mohd Zain: None declared, Azmillah Rosman: None declared

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