This population-based, matched, retrospective cohort study will evaluate the long-term risk of gout among living kidney donors compared with matched healthy nondonors, using linked administrative health care databases from Ontario, Alberta, and British Columbia. Living kidney donors who donated between 1992 and 2024 will be identified and matched 1:10 to a carefully selected population of healthy nondonors based on baseline characteristics. The primary outcome is the first health care encounter with a diagnosis of gout. Secondary outcomes include receipt of a dispensed prescription for the composite of allopurinol, colchicine, or febuxostat, and each medication separately. The findings will provide evidence to inform clinical guidelines, support informed decision-making among potential donors and recipients, and guide counselling by transplant clinicians.