Gout and kidneys: beware of kidney failure

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Extract from the article: Gout is an inflammatory arthritis secondary to crystalline deposits of monosodium urate or uric acid. Uric acid is the end product of the breakdown of certain molecules in the body, in particular purines. Uric acid levels are maintained at a maximum

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Gout is an inflammatory arthritis secondary to crystalline deposits of monosodium urate or uric acid. Uric acid is the end product of the breakdown of certain molecules in the body, in particular purines. Uric acid levels are maintained at a maximum threshold, beyond which hyperuricaemia occurs. If this hyperuricaemia causes arthritis, the condition is known as gout. The kidney is the main organ for regulating the quantity of water and electrolytes and eliminating toxic substances. As part of their function, the kidneys eliminate 2/3 of uric acid. Can gout affect the kidneys as it progresses?

Gout, as it progresses, can cause renal failure by two main mechanisms: firstly, the precipitation of urate crystals within the parenchyma or renal tubules.This causes inflammation and even fibrosis, leading to renal failure.This is followed by the formation of lithiasis or stones based on urate crystals.These stones can then obstruct the urinary excretory tract, preventing the normal flow of urine and causing kidney failure.

In addition to these two mechanisms, certain drugs used to treat the pain caused by gout, in this case anti-inflammatory drugs, can also lead to kidney failure.

What happens when the kidneys are affected?

In the case of kidney failure, uric acid is not eliminated and increases in the blood. This causes or aggravates gout.In addition, certain drugs used in renal failure, particularly diuretics, can also cause hyperuricaemia.So the relationship between gout and the kidneys is a two-way street.Gout can cause renal failure and vice versa.What can be done in this situation?Treating patients requires multidisciplinary monitoring. They can be treated in collaboration with rheumatologists. In these situations, if the renal insufficiency is moderate, dietary hygiene measures are recommended. Molecules are used to reduce uric acid levels and soothe pain while protecting the kidneys.

But in the case of end-stage renal failure, dialysis or renal translation is indicated.

Advice for the general public

Eat a healthy, balanced diet, cut down on red meat consumption, cut down on excessive consumption of alcoholic beverages, drink at least 2.5 litres of water a day and exercise daily. Consult a doctor at least once a year, even if everything is going well, and avoid self-medication.

Elom AKAKPO

Source: Dr Pegdebamba François Kissou, Nephrologist at the Sourou Sanou University Hospital in Burkina Faso