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National Kidney Foundation

National Kidney Foundation

What is Gout, and What Should You Do If You Have It?

What is Gout, and What Should You Do If You Have It?

Learn about gout, a type of arthritis associated with CKD.


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Did you know that a type of arthritis called gout is common among chronic kidney disease (CKD) patients? This is because gout occurs when uric acid levels are too high, which can happen when CKD patients are unable to excrete excess uric acid properly. Learn more about gout, including causes, symptoms, testing, and treatments.* 

What causes gout? 

Uric acid is a normal body waste that comes from the breakdown of purines, a chemical both made by our bodies and absorbed from what we eat. When uric acid levels get too high, hard crystals can form from the acid. Over time, these crystals settle into your joints, causing the inflammation and pain known as gout. 

Who is at risk for gout?

CKD can prevent your body from removing excess uric acid, putting you at higher risk for gout. Some other known risks include:

  • A diet high in purines
  • Certain medicines, like low-dose aspirin and beta-blockers
  • Certain diseases, especially if untreated
  • Dehydration
  • Obesity
  • Age and sex (male, ages 30-50)
  • Family history of gout

What are the symptoms?

Gout often causes intense pain during flare-ups (referred to as a “gout attack”). Along with pain, you may also experience:

  • Stiffness,
  • Swelling, and/or
  • Tenderness of the surrounding tissues.

A common place to experience gout is in the big toe, where more than half of patients have their first gout attack. Gout of the big toe is called ‘podagra.’

How is gout diagnosed?

If your doctor suspects that you have gout, they will likely order one or more of these diagnostic tests. 

  • Arthrocentesis a procedure used to remove and examine fluid from your joints (considered the gold standard for diagnosing gout) 
  • Imaging tests such as an ultrasound, CT scan, and magnetic resonance imaging (MRI)
  • Bloodwork, which may include uric acid levels and other kidney-related blood tests

How is gout managed? 

Treating gout is important, as it can become a long-term, painful problem if left untreated. It can damage joints and even lead to kidney stones. Your doctor will help you to decide the best treatment option depending on your symptom severity, inflammation location, and more. 

Some medicinal treatments your doctor may discuss could include:

  • Medications for gout flares include a pill (colchicine) or injection (cortisone)
  • Long-term treatment pills to prevent flare-ups and lower uric acid may include allopurinol, febuxostat, probenecid, and lesinurad 
  • For severe gout, pegloticase can be given through a vein and may work better than pills

Some ways to help lower your risk for gout flare-ups include:

  • Following a plant-based diet, and avoiding or limiting high-purine foods like organ meats, shellfish, beer, and products containing high-fructose corn syrup
  • Staying adequately-hydrated (ask your doctor about your recommended fluid intake)
    • Losing weight, if needed, and live a healthy and active lifestyle
    • Avoiding NSAIDs such as ibuprofen and naproxen
    • Speaking with your doctor before taking any herbal supplements 
    • Quitting smoking

 

  • Managing any other health conditions like CKD, high blood pressure, diabetes, and heart disease

 

While gout is a serious condition, it can be managed well with few symptoms. Speak with your healthcare team if you think you may have gout or have questions about how your gout is being treated. 

 

*Gout and Kidney Disease. (2021, August 2). National Kidney Foundation. https://www.kidney.org/atoz/content/gout/gout-kidney-disease#:~

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