If you have gout or kidney disease, talk to your doctor about your risk of developing the other condition. While they don’t always occur together, there are times when the two are connected.

If you live with either gout or kidney disease, it’s important to understand how they can be related. This helps you and your doctor make smart, informed decisions about your treatment, helping you stay healthy and maintain a good quality of life.

What Is Gout?

Gout is one of the most common types of chronic (long-term) arthritis. It happens when too much uric acid builds up in the blood, leading to sharp urate crystals forming in your joints. This buildup often affects the big toe but can develop in any affected joint. Gout causes swelling, joint pain, redness, and stiffness during gout flares or attacks.

In acute gout, you'll only feel symptoms when the condition is flaring up, and only a few joints will be affected. Once the flare ends, anytime from a few days to a week, you won’t have symptoms until it flares up again.

Without treatment, acute gout can worsen and turn into chronic gout, which causes more frequent flares — at least two per year — and symptoms that may persist most of the time. Later on, more joints may be affected, and permanent joint damage can occur. Gout also increases the risk of complications like kidney stones, renal disease, and even kidney failure, especially if high levels of uric acid are not managed.

Although you can’t cure gout, it can be managed with lifestyle changes, a balanced diet, and medications like allopurinol or colchicine. We‘ll talk about these in detail later in this article.

What Causes Gout?

Gout develops when you have too much of a chemical called uric acid in your blood. Uric acid is a waste product your body makes. Normally, your body gets rid of it. But sometimes, you make too much uric acid or your body can’t get rid of it fast enough. This is called hyperuricemia.

This acid can build up in your body, including around your joints. Eventually, it begins to form urate crystals, which cause the symptoms you experience as gout.

According to the American Kidney Fund, risk factors for gout include male gender, family history of gout, having a higher body weight, high blood pressure, and diets high in purines — natural substances found in red meat, certain seafood, and alcohol that your body turns into uric acid.

Are Gout and Kidney Disease Related?

These conditions are closely linked because your kidneys filter uric acid from your blood. They can both cause or be risk factors for the other. In fact, about 1 in every 10 people diagnosed with chronic kidney disease (CKD) also have gout. Even more people with gout have some level of kidney dysfunction. Gout is connected to several different kinds of kidney disease because urate crystals can potentially damage kidney tissue.

A rare type of kidney disease called complement c3 glomerulopathy (C3G) can sometimes cause gout. It happens when the kidneys can’t remove enough uric acid, causing crystals to build up in joints like the big toe. It’s one symptom to watch for if you have C3G.

Gout can lead to kidney disease, although this link isn’t as well understood as how kidney disease can cause gout. Many specialists, however, believe it’s real. Doctors aren’t exactly sure why this happens, but they think the same urate crystals that cause joint pain may also cause kidney stones. These stones can lead to infections, scarring, and kidney damage, especially if they aren’t treated. Researchers need to do more work to confirm that this happens, understand the process better, and determine how often this occurs.

If you have gout or kidney disease, ask your healthcare provider about testing for a connection between the two. Many nephrologists may refer you to a rheumatologist or your primary care doctor for gout management. Working with a team of specialists can help improve your kidney health and reduce the symptoms of gout.

How To Manage Gout and Kidney Disease

Managing gout when you also have kidney disease can be complicated, and there’s a lot that researchers don’t know yet. For example, some medications can help manage gout flares, but it’s unclear if they’re safe for people with kidney disease or how to adjust the dosage for different levels of kidney damage. Both conditions share risk factors, like high blood pressure, obesity, and kidney stones, which can make treatment more complicated. Ongoing research highlights the importance of your rheumatologist and kidney doctor working as a team.

Because managing both conditions together can be challenging, you may want to explore other ways to manage gout. Here are some approaches that might help.

Talk About All Medications With a Doctor

Some medications for gout and kidney disease can interact in ways that affect your kidney function or make gout attacks worse. For example:

• Colchicine, a common medication for gout, needs to be adjusted for people with kidney disease to prevent side effects like muscle weakness.
• Allopurinol, a urate-lowering therapy, is often started at a low dose and gradually increased to safely reduce uric acid levels and prevent the buildup of uric acid crystals.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are often avoided because they can harm kidneys.

Always tell your healthcare team about every medication you’re taking to ensure it’s safe for both your gout and kidney health.

Stay as Healthy as Possible

If you have both kidney disease and gout, it’s important to keep your blood sugar and blood pressure in healthy ranges. This can be challenging because some common blood pressure medications, like diuretics and beta-blockers, aren’t ideal for people with gout. You and your doctor may need to find other options to manage your health without making your kidney disease or gout worse.

Change Your Diet

Purines are natural substances found in your body and certain foods. When your body breaks them down, they turn into uric acid, which is usually removed through urine. However, eating foods high in purines, like organ meats, shellfish, and some fish, can raise uric acid levels. Sugary drinks, alcohol, and foods with high-fructose corn syrup can also trigger gout attacks and should be limited. To lower your risk of flares, focus on eating:

• Whole grains
• Fresh fruits and vegetables
• Lean proteins that fit within your kidney-friendly dietary restrictions

Along with following a renal diet for kidney health, consider meeting with a registered dietitian who can help you create a personalized plan to prevent the buildup of uric acid while keeping up with good nutrition. These dietary changes may also help you maintain a healthy weight, which reduces your risk of both gout and kidney disease.

Exercise Regularly

Part of staying well means exercising regularly. If you can exercise five days each week, for at least 30 minutes at a time, that’s ideal. If you don’t feel well enough to do that much exercise, talk to your healthcare team about what might work. They may send you to a physical therapist or another expert who can help you figure out what will work for you.

Talk With Others Who Understand

MyKidneyDiseaseTeam is the social network for people with rare kidney disease and their loved ones. On MyKidneyDiseaseTeam, members come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

Do you live with gout alongside kidney disease? Has your healthcare practitioner explained how the two are related? Share your experience in the comments below, or start a conversation by posting on your Activities page.