Does Gout Affect Your Kidneys – Arthritis affects more than just the joints. Here are the facts about common gout ailments and how to prevent and manage them.
Gout is the painful, acute onset of joint pain caused by a build-up of uric acid (a normal waste product in your body) in the blood. When uric acid builds up in the blood, it can build up in the joints and trigger an inflammatory response that causes severe pain and swelling. Arthritis usually affects one joint at a time (the big toe is a common place to start arthritis), but over time it can affect multiple joints and other parts of the body, especially if not treated properly.
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Does Gout Affect Your Kidneys
With arthritis, your joints can be swollen, red, warm, and tender, says Konstantinos Loubasakis, MD, a rheumatologist at MedStar Washington Hospital Center in Washington. When arthritis flares up, the pain is so excruciating that you can’t tolerate sheets touching the joint.
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“When you have severe arthritis, you can’t move,” says Pooja Khanna, MD, an associate professor in the division of rheumatology at the University of Michigan’s Department of Internal Medicine in Ann Arbor. Drop your training area. “Uric acid sits in the joints, causing chronic inflammation. Your joints become more and more dysfunctional.”
After treatment with steroids such as prednisone and NSAIDs, the pain usually disappears within a few days. Repeated flare-ups of arthritis can lead to chronic joint damage, where bones erode and joint space shrinks. “Chronic complications occur after repeated, untreated attacks,” says Dr. Loupasakis. “You can permanently damage your range of motion. We want to prevent that from happening. This damage is difficult to treat when we get there.”
Dr. Khanna says some patients may go to their primary care physician and seek treatment for a flare-up of gout. They aren’t told that arthritis is a chronic condition like diabetes, high cholesterol or high blood pressure, she says. “I make them realize that arthritis is chronic. If you have a chronic condition, treat it,” she says. “If they don’t know it’s chronic, they think they can use ibuprofen and that’s it.”
Proper treatment is essential for gout. In addition to treating an acute gout attack, lowering uric acid levels with medication can prevent gout flare-ups and the long-term complications that come with them. Medicines called xanthine oxidase inhibitors control the amount of uric acid in the body. These include allopurinol (Ciloprim and Alloprim) and febuxostat (Uloric). Another class of drugs called uricosurics help your kidneys remove uric acid from the body. These include probenecid (Probalan) and lesinurad (Zurambic). An injectable drug called peclodicase (Krystexxa) helps rid the body of uric acid in people whose gout is not well controlled with other medications.
How To Treat Gout Of The Big Toe
Properly treating gout with medications and lifestyle changes can help prevent many of the gout-related problems known as comorbidities. It is important to understand all the possible infections and complications of arthritis. Once you’ve read the list of gout complications, ask your doctor if you have any questions or concerns. You may need to create a health care team with different specialists, such as seeing a rheumatologist and urologist, or facilitate better communication between them to ensure you receive optimal treatment for your arthritis and related diseases.
About one-third of gout sufferers develop tophi. Tophi are urate crystals and inflammatory cells that form under the skin due to gout. They are more likely to occur in people who have had arthritis for a long time or whose arthritis is not well controlled. Gouty toffee can appear on the hands, feet, wrists, ankles, eyes, ears, nose, and even heart valves.
Gouty toffee feel like hard bumps under the skin. John Fitzgerald, MD, a rheumatologist practicing in Los Angeles and Santa Monica, California.
Gout toffee is not just an aesthetic problem. As tophi develop, they can erode the joints and surrounding skin and tissue, causing damage and eventual destruction of the joint. “They start out big and break open through the skin,” says Dr Khanna. Toffee is also prone to infections that require antibiotics. If gouty tophi are infected or very large, they may need to be surgically removed.
Gout And Chronic Kidney Disease
Keeping uric acid levels at a healthy level is the best way to prevent gout. “Treating hyperuricemia [excess uric acid in the blood] prevents crystal growth/deposition. Reducing uric acid causes the toffee crystals to dissolve,” says Dr. Fitzgerald.
Kidney stones are one of the most common complications of gout. They affect one in five gout sufferers. When urate crystals accumulate in your urinary tract, they can form kidney stones. Symptoms of kidney stones include:
“Back and hip pain can be very severe,” says Daniel Furst, MD, a professor of rheumatology at UCLA and the University of Florence who practices in Los Angeles and Seattle. “Women compare it to labor pains.” For people with a history of kidney stones, doctors generally recommend producing about 2.5 liters of urine per day. Your doctor may ask you to measure your urine output to make sure you’re drinking enough water.
To prevent uric acid stones from gout, doctors often prescribe a drug called allopurinol that lowers uric acid. “It reduces the production of urate, therefore reducing the amount of urate in the joints and urine,” says Theodore R. Fields, MD, FACP, is a rheumatologist at the Hospital for Special Surgery in New York City. Sometimes, allopurinol and an alkalizing agent can dissolve uric acid stones. To prevent the formation of calcium stones, your doctor may prescribe a thiazide diuretic or a phosphate-containing product.
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About 1 in 10 people with chronic kidney disease have gout, and an even higher percentage of people with gout also have kidney disease. “Uric acid is processed by the kidneys,” says Dr Khanna. “With age, the kidneys can no longer process uric acid,” says Dr Khanna. Damage from urate crystals can lead to kidney disease over time, especially if gout is not properly treated.
Early symptoms of kidney disease include fatigue, weakness and low energy, says Dr. Furst. However, the kidneys are amazing at compensating for problems in their function, so chronic kidney disease can progress for long periods of time without symptoms. When kidney function is severe, people may experience symptoms such as ankle swelling, nausea, fatigue, and loss of appetite.
This is why regular monitoring of kidney function is so important in patients with gout. “It’s important to detect changes in kidney function early in the course of gout so that efforts can be made to preserve remaining function, such as controlling blood pressure,” says Dr. Fields. “Gout medications may require dose adjustments if kidney function changes.”
Arthritis and heart disease often occur together. In a study published in the Journal of the American Heart Association, Duke University researchers analyzed data from more than 17,000 patients, including 1,406 who had arthritis at the start of the study and were treated for cardiovascular risk factors. After following the patients for an average of 6.4 years, the researchers found that the risk of dying from cardiovascular disease or having a heart attack or stroke was 15 percent higher than those with gout. Patients who developed gout at any time during the study had twice the risk of dying from heart failure compared to those who did not develop gout.
Kidney Disease: Does Gout Increase Risk?
Arthritis causes inflammation in the joints and other parts of the body; Inflammation is a risk factor for heart disease. Heart disease prevention strategies include a heart-healthy diet, regular exercise, and a good cardiovascular risk assessment. Your doctor may recommend more frequent screening tests or more aggressive management of other heart disease risk factors associated with gout, such as high blood pressure.
A study published in the journal Annals of the Rheumatic Disease found that arthritis may be independently associated with an increased risk of type 2 diabetes. Scientists aren’t exactly sure why arthritis and diabetes are linked, although inflammation may be a common factor. If you are overweight or obese, you are more likely to develop gout and type 2 diabetes. Excessive alcohol consumption can contribute to both gout and diabetes.
Diabetes and arthritis can be prevented and controlled by maintaining healthy eating and exercise habits. Eating foods that are low in calories and fat but high in fiber (fruits, vegetables, and whole grains) can help reduce the risk of diabetes. Drink at least eight cups of water a day; Staying hydrated can help maintain healthy blood sugar levels. If you are overweight, try to lose weight. Cardio and strength exercise are particularly effective in lowering blood sugar levels.
Because gout attacks usually occur at night, people with gout wake up from sleep. Pain from arthritis can prevent you from falling again
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