May 28, 2008

Complications of Gout (Gouty Arthritis) – Renal Disorders & Inflammation

Posted in Category : Bone, Joint & Muscles Disorders

Gout (gouty arthritis) is a complex disorder which is characterized by inflammation of joints due to deposition of uric acid crystals in the tissues. Main causes of gout are higher levels of uric acid, obesity, high intake of food containing purines, high alcohol intake and abnormal kidney function. The joints of ankles, knees, feet, wrists, hands and toes are affected by this disorder. The affected joints become red, tender and swollen. When the disease becomes chronic, it can give rise to some complications. The complications of gout (gouty arthritis) are serious and can affect overall health.

In the advanced stage of disease, there may be deposition of uric acid crystals in bursae (small fluid-filled sacs) around the joints which can cause bursitis resulting in swelling and pain around the joints. In some rare cases of gouty arthritis, there may be more chronic type of joint inflammation which is similar to rheumatoid arthritis.

In the chronic condition of gouty arthritis, there may be deposition of nodular masses of uric acid crystals in various soft tissue areas. They are most frequently found as hard nodules around the fingers, around the big toe and at the tips of elbows. Formation of tophi (uric acid crystals) nodules is one of the significant complications of gout (gouty arthritis). Tophi nodules may be seen anywhere in the body such as vocal cords, ears and rarely around the spinal cord. Tophi may grow to the size of handballs which can destroy cartilage in the joints and bone. If lodged in the spine, tophi can give rise to serious damage such as compression. In extreme cases, destruction of joints may result in complete disability.

Development of kidney stones is among the important complications of gout (gouty arthritis). About 10-40% of patients with gout may suffer from kidney stones due to hyperuricemia. Although the stones are composed of uric acid, they can be formed of other materials. Approximately 25% of patients having chronic gouty arthritis develop progressive kidney disease which may result in kidney failure. However, in some cases, high concentrations of uric acid may result from the kidney disease. Elevated levels of uric acid can lead to impaired kidney function.

Besides these complications of gout (gouty arthritis), gout may be associated with some heart problems such as coronary artery disease, high blood pressure and congestive heart failure. Recurrent gout and high uric acid levels may be related to high blood pressure. The combination of high blood pressure and hyperuricaemia may result in kidney damage.