The body is a collection of complex systems that interact closely with each other to keep your body healthy and functioning as it should. For example, the skeletal and muscular systems support you and help you move, while your digestive system and circulatory system work to deliver essential nutrition to cells throughout the body. Unsurprisingly, when one system fails or dysfunctions, this can lead to secondary conditions. Enter the connection between gout and kidney disease.

What is Gout?

To understand the connection between gout and kidney disease, you must first understand how gout occurs. Excess uric acid in the blood causes the formation of uric acid crystals around the joints, resulting in an incredibly painful form of arthritis called gout[1]. Gout is usually localized in the joint of the big toe and can cause swelling, stiffness, redness, warmth, and tenderness. Many people with gout report that even the weight of bed sheets is too painful to endure during a gout attack.

Gout treatments vary patient to patient, but reducing purines in the diet—which get broken down into uric acid in the body—can often help prevent flares. Foods high in purines are sugary drinks and sweets, high fructose corn syrup, alcohol, organ meats, game meats, certain seafoods, red meat, and deli turkey. Certain health conditions can also lead to gout, including obesity, congestive heart failure, diabetes, hypertension, blood cancer (like leukemia and lymphoma), and kidney disease.

The Link Between Gout and Kidney Disease

Gout can be a symptom of kidney disease, and if gone untreated can cause additional damage to the kidneys.[2]

When there is excess uric acid in the blood, it’s possible that the kidneys won’t be able to filter enough of it out of the body through urine. Over time, the kidneys can become less efficient and ultimately progress through the states of kidney disease and possibly kidney failure. A study conducted by the University of Limerick published in 2019 suggested that uncontrolled gout more than doubles the risk of kidney failure.[3]

Gout and kidney disease can develop in either order. While there does appear to be a more established correlation between existing kidney disease and the onset of gout, gout itself can also decrease kidney function, and the cycle goes on and on. Treating gout appropriately and controlling flares can also help in treating kidney disease and even high blood pressure.

Kidney Disease Can Lead to Gout

Kidneys filter blood, and healthy kidneys can do this very efficiently. They remove waste, toxins, and excess fluid. Healthy kidneys play a part in stimulating red blood cells, controlling blood pressure, keeping bones healthy, and regulating all of the chemicals that your body processes.[4] Gout and kidney disease disrupt this important process.

Chronic kidney disease (CKD), also known as chronic renal disease, is the gradual loss of kidney function over time, which means less and less wastes are filtered out of the body. Kidney disease symptoms include anemia (a low number of red blood cells), an increase in infections, loss of appetite, and depression. Blood tests may also show low levels of calcium, high levels of potassium, and high levels of phosphorus—as well as high levels of uric acid.

Kidney disease is linked to a number of risk factors, including diabetes, high blood pressure, recurrent urinary tract infections, smoking, obesity, heart disease, and the overuse of certain medications. A family history of kidney disease and being of older age also increases your chances of developing CKD.

Many times, there is underlying kidney disease before gout develops. When uric acid isn’t being properly filtered due to unhealthy kidneys, it can collect elsewhere. And this is how gout can strike.

Danger of Untreated Gout and Kidney Disease

Refractory gout is a rare form of severe gout that can lead to permanent joint damage, trouble with movement, and difficulty walking.[5] In addition to buildup of uric acid in the joints, refractory gout can also create lumps in the hands and elbows, which are painful and disfiguring deposits called tophi.

Left untreated, gout and kidney disease can cause intense amounts of pain and can lead to severely decreased kidney function. Damaged kidneys limit their filtering process, which can impact the entire body. Blood flows to every body part, and if blood isn’t properly filtered, other body systems can start to fail, including memory and the ability to think clearly. Late-stage kidney disease can cause damage to the heart, lungs, central nervous system, and bones.

Thankfully, dietary and lifestyle changes, along with proper medication, can help prevent gout attacks and lower uric acid levels. There are times that this can even lead to lower blood pressure, better control over blood sugar, and possibly decreased need for multiple medications.[6]

CKD treatment may include:[7]

• Blood pressure medications
• Low protein diets
• Cholesterol medication
• Dialysis
• Kidney transplant

Properly managed gout reduces your risk of developing kidney disease. And if you currently have gout and kidney disease, it’s more important than ever to get treatment. Summit Rheumatology helps patients with all stages of gout manage their diagnosis and reduce painful gout flares. This can then lead to healthier kidneys, improved blood pressure, decreased pain, and a better mood.

Give us a call at (480) 494-2770 or contact us here to schedule an appointment with one of our gout specialists.