2015年11月20日星期五

Gouty Nephropathy: Kidney Damage due to Hyperuricemia

In gouty, the uric acid in their blood is usually very high. This condition is called hyperuricemia. If left untreated over time, it will lead to kidney damage including two types.

First, hyperuricemia itself can cause inflammation and damage to kidneys, which is called Gouty Nephropathy. In Gouty Nephropathy, the urate mainly deposits in the renal tubule and renal interstitium, leading to atrophy of renal tubular epithelial cells, damaging the function of renal tubule. There will be edema, inflammation reaction in the renal interstitium. Untreated over time, the kidneys will have fibrosis, which is called Interstitial Nephritis clinically. The damage to glomeruli due to uric acid is milder than that to renal tubule and renal interstitium. However, the uric acid still can lead inflammation to glomerular capillaries and glomerular basilar membrane and even cause glomerulosclerosis.
Gouty Nephropathy can cause kidney damage in a chronically progressive way. The patients can maintain normal renal function for a long time. With the progression of the disease, the patients will have edema, declined urination at night, hypertension, and anemia and so on. Finally it will develop into End Stage Renal Failure.

Second, the urate crystallizes separating out and even forms stone depositing in the kidneys and ureter and other parts thus leading to secondary kidney damage. Clinically, the gouty stones in the kidneys, ureter, bladder and urinary tract are called urinary system gouty stone. There are two sources of urate: urate deposits in the bladder or ureter, forming gouty stone. Occasionally, the stone also can be found in the urethra. In addition, the stone in the kidneys can enter urinary tract or bladder. For the patients with stone in ureter or bladder, nearly all of them have Gouty Nephropathy or Kidney Stone in varying degrees. If the diameter of stone exceeds that of ureter, it will lead to obstruction thus causing nephredema or hydroureter. In mild case, it may not cause clinical symptoms. However, if hydroureter is serious, the patients will have back pain or swelling feeling in the kidney area and so on. Left untreated, it will cause the renal function to decline gradually and finally progress into Renal Failure.


Therefore, if you have a history of gouty, you should do blood test, urine test and renal function test and so on regularly so as to find if they have kidney damage in the first time and treat the disease as early as possible.

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