Gout is a painful disease that occurs when uric acid, a normal waste product, builds up in the blood and forms crystals in the joints and/or kidneys.
Uric acid normally dissolves in the blood, processes through the kidney, and leaves the body in the urine. If the body makes extra uric acid, or if the kidneys cannot clear enough of it, then uric acid levels in the blood will become too high, a condition known as hyperuricemia.
Hyperuricemia is not a disease and may not cause problems, but if it continues for a long time and conditions in the body are right, crystals may form and cause gout. Most experts recommend that uric acid levels stay below 6.0 mg/dL in order to prevent gout attacks.
Uric acid comes from the breakdown of purines, naturally-occurring chemicals that are found in both our diets and our bodies. Foods and drinks that contribute most to hyperuricemia and gout include red meat, organ meat, seafood, beer, liquor, and sugar-sweetened items, especially with high fructose corn syrup. Health problems such as obesity, high blood pressure, high blood sugar, and high cholesterol may also lead to increased uric acid and the development of gout. And because some medications may also increase risk, you should review all your medications and supplements with your doctor. Other causes of hyperuricemia and gout include kidney disease, exposure to lead, hypothyroidism, severe illness or stress, and extreme physical exertion.
Some people with gout do not have high uric acid levels, so it is very important to maintain a healthy lifestyle no matter the level. Do not smoke, follow a well-balanced diet, maintain a healthy weight, and exercise.
Joint and Kidney Damage Caused by Gout
Uric acid crystals deposited in the joints can cause pain, swelling, stiffness, and deformity, and impair movement.
Uric acid crystals deposited in the kidneys can become large stones. These stones are very painful and can cause permanent kidney damage by 1) forming an obstruction that prevents your kidneys from removing wastes and causing infection, and 2) scarring the kidneys with rough or sharp edges. Both problems can lead to chronic kidney disease and even kidney failure.
Chronic kidney disease occurs when the kidneys have been damaged and/or kidney function has been greatly decreased for more than 3 months, and it is detected with routine laboratory tests. One of these tests is estimated glomerular filtration rate (eGFR) which determines the level of kidney function. Another test measures albumin in the urine and is called urine albumin-to-creatinine ratio (ACR). Albumin in the urine may be a sign of kidney damage.
Kidney failure occurs when kidney function is so poor that there are severe symptoms, or when there is a need for dialysis or transplant to treat complications that could lead to more sickness and death.
Prevent Gout Attacks and Kidney Damage
Focus on lifestyle changes to reduce your risk for developing gout and kidney damage. High uric acid is the strongest risk factor for developing gout, but if you eliminate the causes of a high uric acid such as obesity and high blood pressure, then you may prevent gout attacks.
Follow a healthy diet that contains mostly vegetables and fruits, whole grains, and low-fat dairy products. Limit sugar-sweetened foods and drinks, especially those that contain high fructose corn syrup. Limit alcohol, meat, and fish, especially shrimp and lobster. Avoid crash diets because they can make the urine more acid, which makes it harder for uric acid to dissolve.
Drink at least 64 ounces of water a day (8 cups) to help reduce the risk for stone formation.