SI
Dr. Sreesh IyengarNephrology

Gout and kidney disease

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Gout is a condition of elevated Uric acid in the blood with joint related symptoms or signs. It occurs more frequently in those with chronic kidney disease.
Gout has been associated with chronic kidney disease as well as other systemic conditions including coronary disease and high blood pressure.
Diet modifications do very little to improve uric acid levels and should not be advised alone when gout is being treated. Avoidance of alcohol and high intake of red meats should be limited or avoided along with medications.
The kidneys handle 70% of your body’s uric acid load while the gut handles 30%. Only about 10% of the filtered uric acid in the kidneys is excreted due to high reabsorption of uric acid after it is filtered.
Asymptomatic patients with elevated uric acid levels should also be treated, even in the absence of gout, due to the possibility of downstream systemic effects. 
Diagnosis of gout requires a joint aspiration to obtain joint fluid to be viewed under a microscope. One is looking for needle like crystals in the microscope. Newer imaging techniques are around to identify uric acid deposits in the body.
Mainstay of treatment has been anti inflammatory medications. Steroids are also used for treatment whether by mouth or by injection into the affected joint. Newer therapies now also exist but you should see a specialist for these.