Gout is one of the most common forms of arthritis—along with osteoarthritis, rheumatoid arthritis, lupus, and fibromyalgia—which is the leading cause of disability. According to The Centers for Disease Control and Prevention, an estimated 54.4 million U.S. adults suffer from arthritis, about one quarter of the population. About eight million of those are affected by gout.
The symptoms of gout, and what make it so disabling, are sudden, severe attacks of pain in the joints, including redness and tenderness. This often occurs at the base of the big toe, and men and people with kidney disease are more susceptible than others. It occurs when high levels of uric acid in the body, including in the bloodstream—called “hyperuricemia”—cause urate crystals to form and accumulate in and around the joints. These crystals then attract and activate white blood cells, leading to gout attacks or “flares.”
High uric acid may also cause chronic kidney disease (CKD). As the uric acid moves through the blood to the kidneys, the kidneys add it to the urine so it can leave the body. If there’s too much uric acid, the kidneys can’t remove it all and it builds up in the blood. The uric acid can also form kidney stones, which can lead to infection scarring, and ultimately kidney failure.
According to the National Kidney Foundation, 26 million American adults have kidney disease, and most don’t know it. Today, in addition to dietary and lifestyle changes, the most common treatments for gout flares include anti-inflammatory drugs or medications and corticosteroids for pain relief, plus prescription medications that reduce the amount of uric acid the body makes. These recommendations and medications help many patients control gout, but they work in varying degrees, and long-term use may cause side effects.
According to an article published in the Cleveland Clinic Journal of Medicine, managing gout when CKD is present is a major challenge. Some drugs used to treat gout—especially in combination with other medications for conditions such as hypertension, insulin resistance, coronary artery disease, and heart failure—need to be adjusted or even avoided when the patient also suffers from CKD; if not, serious side effects can occur.
However, there is hope. Professor Sunil Bhandari, Consultant Nephrologist/Physician at Hull and East Yorkshire Hospitals NHS Trust and Hull York Medical School, commented on an article published by the National Institute for Health Research reviewing small trials that used gout medications to slow the progression of CKD: “Treating high uric acid levels, which causes severe joint pains (gout), now has more added benefits. Evidence is mounting on the strong association of uric acid-lowering treatment on both heart events and progression of kidney disease.”
Gout research studies help identify risk factors, determine which medications can treat and prevent gout, help determine which may also be effective in those with gout and CKD, and how to reduce the likelihood of those medications causing side effects.
Research is critical to improving prevention and treatment, and eventually finding a cure. Meridien Research is conducting gout-related research studies at our Tampa clinic. For more information or to see if you or someone you know may qualify to participate, please contact us today at 1-888-777-8839.