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Hi,
Writing on behalf of my husband who is suffering (and I mean suffering!) with gout. He was diagnosed with nephrotic syndrome 7 years ago, his kidneys are leaking protein. Began to suffer with gout 2 years ago. In the last six months he gets an attack of gout every 2 to 3 weeks. Can be in shoulder, wrist, knee or ankle usually on the right hand side.He takes 300mg Allopurinol daily and when he has an attack, Colcichine 1.5g for 5 days. It has gotten so bad that his gout reappears within a week of each treatment. Local doctor is no help at all. He has been revisiting him for months and he offers no solution or referral. No idea what uric acid level is as we have never been told! Any advice / help/ experience would be gratefully appreciated. His gout condition seems to be a result of the kidney disease rather than diet so we are at a loss as to what can help.
Uncomplicated gout can be treated by some general doctors, but your husband must see a rheumatologist.
Even the rheumatologist might have to consult with a neprologist (kidney specialist) to get the right medication package.
Controlling uric acid is absolutely vital, but only an expert can conduct the right tests and interpret the results correctly to make sure the right treatment is prescribed.
Experience from other contributors suggests that you should ask the rheumatologist about their experience with treating gout / nephrotic syndrome patients before you consult. These complications are beyond some specialists, and way beyond most family doctors (though some good ones have consulted properly to learn correct procedure).
It is definitely beyond online advice, though we will try to explain procedures and terminology where we can.
Please book that appointment now.
Everything GP has said is spot on.
Let me add that high uric acid levels can damage kidneys and damaged kidneys excrete uric acid poorly. It is a vicious circle and it's hard to say what came first, the hyperuricemia or the kidney damage.
Get his serum uric acid level checked YESTERDAY and ask for a 24 nour uric acid urine test. There is nothing sacrosanct about 300 mg. allopurinol, he may need more, up to 800 mg. The serum uric acid test will answer that question…you want to see a number below 6.0 mg.dL.
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