Renal functions in patients with gout and no signs of chronic renal disease

Abstract

The gout prevalence has increased during last decade, 30–50% of gouty patients have kidney involvement. Objective. To assess kidney function and to identify possible relationship severity of the gout with kidney dysfunction we studied 29 healthy volunteers and 62 patients with gout and no signs of chronic kidney disease (CKD). Results. In gouty patients with normal glomerular filtration rate, without proteinuria we have found not only hyperuricemia 510 [410; 633] mM, but decreased uric acid (UA) clearance 5,3 [3,8; 7,5] versus 10,3 [7,4; 11,4] ml/min/1,73 м² and excretion fraction, against background increase of filtered volume and reabsorbion. There is a significant linkage between the UA level and the presence of tophi, quantity of affected joints, exacerbation frequency, X-ray stage, and severity indexes. A relationship was found between the functional failure of arthritis with renal exchange of UA (excretion fraction), but not with the level of blood UA. Conclusion. To set up the of purine metabolism, the prognosis of gout and selection of medication it is important to evaluate the UA level, the UA clearance and the excretion fraction. Decreased UA clearance may be suggested as the first stage of uric acid nephropathy as the UA clearance £7 has sensitivity of 69%, specificity of 77% and + likelihood ratio 3.