What is the treatment for nephropathy in gout?

The main goal of therapy for gouty nephropathy – getting rid of the underlying disease, that is, gout, as well as the removal and dissolution of crystals of uric acid salts. With the simultaneous presence of kidney stones, surgical intervention is also indicated. The main components of the treatment of nephropathy in gout include the appointment of a special diet and specific drugs that can dissolve urate and improve the process of excretion of uric acid in the urine.

The set of tasks and methods of therapy used in such treatment mainly depends on the form of the disease, which can be clinical or chronic. Read more about the treatment of nephropathy in our article.

What determines the prognosis of the course of nephropathy? Principles of treatment of nephropathy

The basic principles of the treatment of nephropathy are discussed above. In addition to its most important goals, namely getting rid of gout and dissolving salts, it should also be aimed at the implementation of other tasks that depend on the individual characteristics of the course of the disease. For example, to lower pressure in the arteries, treat pyelonephritis, normalize the amount of uric acid.

The prognosis and course, as well as the treatment of gout nephropathy, depend on its form and type. For example, tubulointerstitial chronic nephritis (CTIN) can be latent, that is, not typical for acute nephropathy. In this case, it will take time to establish the correct diagnosis, which can aggravate the prognosis of the course of the disease.

What are the main treatments for nephropathy?

There is a difference between the chronic form of nephropathy with gout and acute uric acid nephropathy. In the latter case, active infusion therapy is used (taking special solutions in combination with furosemide and allopurinol). The chronic form requires complex treatment of nephropathy, which involves getting rid of various additional symptoms and complications.

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Common treatments for gout nephropathy are:

1. Diet. It includes the consumption of low-calorie foods, a decrease in the amount of meat, fish, beans consumed, as well as an increase in the amount of liquid drunk per day (up to 2 – 2.5 liters). We are talking about a plentiful alkaline drink.
Allopurinol drug. Its daily intake, as a rule, is in the range of 200-600 mg / day (the amount may decrease with a decrease in CF). It is prescribed for chronic TIN and urate nephrolithiasis. Often, taking this remedy is combined with other drugs that help dissolve salt crystals.
Uricosuric agents. In the chronic form of gouty nephropathy, they are contraindicated, but they can be used in the treatment of chronic TIN. It is also possible to combine them with other drugs.
4. Mixtures of citrates. Used in the treatment of nephropathy forms of urate nephrolithiasis. Their task – dissolve small salt formations.
5. Antihypertensive drugs.
Lipid-lowering drugs. Applicable for gout LDL levels greater than 130 mg/dl.

Variants of the course of nephropathy in gout

Such forms of gouty nephropathy as urate nephrolithiasis and chronic TIN most often manifest themselves during a long course of chronic gout, accompanied by periodic exacerbation of arthritis. The prognosis for the development and treatment of nephropathy of these forms is characterized by their prolonged course.

It is also worth noting that in a few cases, nephropathy hides a renal type of gout or manifestations of rheumatic diseases. In the case of CTI, the course of the disease may be hidden.

There may also be cases of urate nephrolithiasis with recurring symptoms of postrenal acute nephropathy. Acute uric acid nephropathy is more typical for its case, that is, its course is cyclic.

It is important to take into account the factors that increase the risk of nephropathy flowing into a chronic form.

Risk factors for chronic nephropathy: