Gout As Kidney Disease

Content

• Do You Know All The Myths & Facts About Gout?
• Understanding The Kidney Disease And Gout Connection
• How Can I Track My Labs And Gout Flares?
• Chronic Kidney Disease Patients More Likely To Have Gout Than Those Without Ckd, Study Finds
• The Management Of Gout In Renal Disease

Kidney stones can also cause urinary tract infections because they harbor bacteria. David Ozeri, MD, is a board-certified rheumatologist from Tel Aviv, Israel specializing in arthritis, autoimmune diseases, and biologic therapies. Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. However, vitamin C supplements are something to be careful with if you have kidney issues as the kidneys are responsible for getting rid of any excess vitamin C.

Additional sensitivity analyses using different definitions to identify patients with gout confirmed the findings from our main analysis. Among patients with 2 gout diagnoses and at least 1 gout medication use, high sUA levels significantly predicted a higher risk of new onset of kidney disease relative to low sUA levels (HR 1.44, 95% CI 1.20–1.72). The risk of new kidney disease was also higher for high versus low sUA levels (HR 1.49, 95% CI 1.24–1.79) when the analysis was conducted only on patients with at least 3 gout diagnoses . The examination of the urine in this condition also reveals no blood and little protein. A key difference between this condition and ADTKD is that it is autosomal recessive. In this condition, a single child or siblings may be affected.

Do You Know All The Myths & Facts About Gout?

Left unchecked, you can be at increased risk of heart attack, heart failure, or stroke. For the study, Neogi and her colleagues evaluated kidney function in gout patients after starting allopurinol. They used data from the Health Improvement Network, a general practitioner medical records database representative of the United Kingdom’s general population. Gout affects around 1–2% of the Western population at some point in their lifetimes and is becoming more common. This rise is believed to be due to increasing life expectancy, changes in diet and an increase in diseases associated with gout, such as metabolic syndrome and high blood pressure. Factors that influence rates of gout include age, race, and the season of the year.

When you have kidney disease, your kidneys don’t work as well as they should to remove uric acid from your body. About 1 in 4 people with moderate to severe kidney disease also have gout because diseased kidneys can have a harder time removing uric acid. Even healthy kidneys can only get rid of about 10% of the uric acid they process. This retrospective cohort study utilised data from the Clinical Practice Research Datalink .

Understanding The Kidney Disease And Gout Connection

The impairment of the kidney function which results from the action of these mycotoxins reduces uric acid excretion and results in the accumulation of uric acid in the body. ] such as the erosive arthritis of gout and the interstitial fibrosis in many forms of chronic kidney disease. He advocates for increased awareness about living with chronic kidney disease and gout. I still remember a trip to the emergency room about a decade ago. Looking back, I realize there was actually I lot I didn’t know about the two conditions that would have such an impact on my life.

What removes uric acid from the body?

Normally, your body filters out uric acid through your kidneys and in urine. If you consume too much purine in your diet, or if your body can't get rid of this by-product fast enough, uric acid can build up in your blood.

This dataset includes the birthdate, sex, medical procedures, prescriptions, and disease diagnoses according to the International Classification of Diseases, Ninth Revision, Clinical Modifications (ICD-9-CM), of the insured. Information that can be used to identify patients or caregivers is encrypted before data release. Our study was approved by the Research Ethics Committee of China Medical University and Hospital (CMUH-104-REC2-115).

Tophi occur when the person’s blood uric acid level remains high over a long period of time. These precipitates can become quite large, resulting in bumps and swellings on the joints. These swellings can occur on the knee, the elbow, the big toe, and many other joints. Sometimes they open up and leak white, chalky material that is composed of uric acid. If too much uric acid builds up in the fluid around the joints , uric acid crystals form.

A condition known as uric acid nephrolithiasis is when there is a low urine pH, low urine volume, that lead to uric acid stone formation. However, NSAIDs can cause kidney disease and are not recommended if there is a family history of kidney disease. Another anti-inflammatory drug is colchicine and may be prescribed to help with gout. It’s important to note that the side effects of this group of medications can include nausea, vomiting, stomach pain, and diarrhea. And as mentioned above, an x-ray or ultrasound of the affected joint can also be used to look for the uric acid crystals.

That recommended dosing strategy has never been shown to reduce the risk of adverse events, and as Vargas-Santos and Neogi point out, leads to chronic undertreatment of hyperuricemia. Like so much else in medicine, so long as we counsel well and “start low, and go slow,” the most worrisome adverse events can be minimized and caught early. The authors further emphasize the importance of urate monitoring and continued dose adjustment to achieve the desired urate.

Urate

The outcome was defined as either GFR of less than 60 mL per minute on at least 2 occasions more than 90 days apart within 1 year with no intervening GFR of 75 mL or more per minute; hemodialysis or peritoneal dialysis; or kidney transplant. Arthritis caused by gout may lead to bone erosion and cartilage loss leading to complete destruction of the joint. As tophi continue to grow, they can erode the surrounding skin and tissues of the joints. Tophi feel like hard bumps under the skin and are usually not painful, except during gout attacks when they become inflamed and swollen. KRYSTEXXA is a prescription medicine used in adults to help reduce the signs and symptoms of gout that are not controlled by other treatments. Although the scientists accounted for a wide range of factors in their analysis, because the study is observational, there is the possibility that an unmeasured variable plays a pivotal role.

Gout May Lead To Kidney Disease

Despite the unknown mechanism of gout, it is suggested that the effects on CKD may include the activation of inflammatory, proliferative, and other maladaptive pathways by elevated levels of urate. The prevalence of CKD stage ≥ 3 in gout was found to be 24% in our recent systematic review and meta-analysis . We identified only two other prospective studies examining the risk of CKD associated with gout. These studies reported an increased risk of ESRD of 57% and 80% , in keeping with our risk estimate for CKD stage ≥ 3. One study published subsequent to our systematic review found three times increased risk of “renal diseases” following gout diagnosis but did not differentiate between acute or chronic forms .

Therefore, to avoid these nightmare outcomes, it is important that you see your urologist as soon as possible, so they can recommend a uric acid blood test be done, to check your level of uric acid. If your uric acid levels are determined to be too high, or you have been given a diagnosis of gout or kidney stones, the best treatment will be recommended based on your case. If you have gout and want to decrease your chances of developing kidney stones in the future, your urologist will recommend that you should keep your uric acid levels low. Certain medications can help with this, in addition to exercise, eating a diet with low uric acid levels or high-purine foods, and constantly drinking water to stay hydrated. Being hydrated will help flush the uric acid out your system and reduce the chance of it building up. The researchers concluded that the use of allopurinol in the management of gout is not only safe, but also potentially beneficial in reducing the risk of kidney disease.

Chronic Kidney Disease Patients More Likely To Have Gout Than Those Without Ckd, Study Finds

Urate crystals may collect in the urinary tracts of people with gout, causing kidney stones. Gout may occur after taking certain medicines, such as hydrochlorothiazide and other water pills, which may cause a higher level of uric acid in the blood. Cyclosporine or tacrolimus are medications used to suppress the immune system in people with organ transplants and can also increase blood level s of uric acid. Niacin is used to treat high triglycerides and can also increase the risk of gout. Gout is caused by high levels of uric acid, above 7.0 mg/dL in the blood.

Being dehydrated can also increase the concentration of uric acid in the blood. Other possible risk factors can include obesity, age, and family history of gout. People who experience end-stage renal disease typically have long-standing diabetes, high blood pressure, polycystic kidney disease, and internal scarring of both kidneys. Accordingly, the renal failure patient needs a fresh start to be able to enjoy a good quality of life—which they can achieve by having their damaged or nonfunctioning kidney replaced. If you are a person who eats a lot of plant-based or animal-based foods, you may have a large amount of uric acid in your body, which can be detrimental to your health. When your diet contains a high concentration of purines, the uric acid levels in our blood increases, which can cause further complications such as gout, where solid crystals of uric acid form and build up within your joints.