Gout results from increased blood levels of the chemical urate that precipitates in the joints and causes painful gout attacks. Gout is of particular relevance to Aotearoa New Zealand due to the high prevalence and severe disease in Maori and Pacific people. Gout is also associated with diabetes, chronic kidney disease and heart disease. Genetic inheritance is important in determining levels of urate and gout and is known to interact with environmental risk factors such as alcohol, sugary drinks, and diuretics. Our goal is to precisely understand the genes that are important and how they work with diet and diuretics to influence urate levels and gout. We will also investigate whether genetic makeup influences how people respond to the gout drug allopurinol. We anticipate this research will contribute substantially to gout treatment guidelines and increase scientific and medical knowledge and public awareness of the causes, treatment and prevention of gout.