Jicht en diuretica; nog steeds problematisch

A recent case-control study on the effect of diuretics on the incidence of gout included 70 cases, i.e. patients who had experienced their first attack of gout during a period of 8 years and 210 matched controls without gout. Of the 70 new gout cases, 14 had been using diuretics during the 8-year period for at least 3 consecutive months preceding the gouty attack. Regression analyses suggested that diuretics did not independently increase the risk of gout, and that the association between diuretics and gout was completely confounded by cardiovascular indications for diuretic therapy. It may be argued, however, that, taking into account the earlier reported relatively small increases in the incidence of gout at increasing levels of uric acid, the reviewed study lacks the statistical power needed to prove that diuretic therapy is not an independent risk factor for gout. Therefore, the generally accepted guideline still stands that if gout develops during diuretic therapy, this medication should be stopped if possible.