Connection Between Gout And Kidney Stones
Gout is a joint disease, closely related to the deposits of needle-like crystals that cause inflammation in the joint. Fortunately, it is very treatable and even some sufferers never have another flare-up after following appropriate treatment plan. However, if it is not well controlled, it can cause kidney disease, such as kidney stones.
Introduction, understanding the function of the kidneys in general
Normally, you have a pair of kidneys . The size is similar to a fist, about 4-5 inches in length.
The blood circulation is so crucial to distribute O2 and nutrients to cells of the body, and carry waste products to the kidneys to be removed with urine. A pair of your kidneys is important to maintain the balance of fluid and electrolytes in the body, too.
The kidney has lots of microscopic filter unit called nephrons. There are million nephrons in each kidney.
As the kidneys work and filter waste products from the blood, they make urine. Then urine and the waste products will go to the bladder through ureters, which then eventually will go away from the body when you pee.
There are numerous conditions that can affect the kidneys, and kidney stones are one of them. Unfortunately, in some cases, a significant drop of kidney function can go without any symptoms, particularly true at early stage of the problem.
The connection between gout and kidney disease
Diet for gout and kidney stones
Risks And Side Effects
Although the low-purine diet is often recommended to minimize gout attacks and reduce symptoms, other medications and treatment methods may also be necessary. For example, anti-inflammatory medications are often prescribed to relieve symptoms during a flare-up and other types medications are also sometimes used to decrease uric acid production in the body.
Additionally, keep in mind that a low-purine diet may not aid in the prevention of all types of kidney stones. In fact, if you have calcium oxalate, cystine or struvite kidney stones, other dietary modifications, lifestyle changes and treatment methods may be required.
Because many of the animal proteins high in purines are also rich in other important nutrients like zinc, iron and omega-3 fatty acids, its also crucial to ensure that youre getting these vitamins and minerals from other sources in your diet.
Although you can enjoy nutrient-rich foods like beef and seafood in moderation as part of a low-purine diet, you should also consume a variety of other healthy foods like vegetables, beans, nuts and seeds to help fill in any gaps in your diet.
Who Is At Risk For Gout
In general, gout is more common in men. Additional risk factors for gout include obesity, high blood pressure, congestive heart failure, insulin resistance or diabetes, or kidney disease.
Those with kidney disease are at a higher risk for developing gout due to the limited ability to remove uric acid from the body.
Other risk factors for developing gout include using certain medications , drinking alcohol, or a diet high in sugar or purines.
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But My Friend Followed An Isolate Diet With Keto And Had Kidney Stones
An increased level of uric acid in the blood is one of the significant consequences of the Metabolic Syndrome. And, during the ketosis state, excessive ketones are excreted mainly via the urine. However, our body also removes them via feces and the breath .
With that said, it is possible for someone on a keto diet despite containing low amounts of purines to develop kidney stones.
Clearly, there must be another contributory factor other than a diet rich in purines.
Such a scenario is especially noticeable in the early weeks of a ketogenic diet protocol which may contribute to gout or kidney stone. At this stage, the body cells dont have all the enzymes needed to use ketones as a source of energy altogether. As a result, some of the unutilized ketones are removed from the body.
Ketones are a little bit acidic and therefore tend to increase the acidity of urine. Leaving this condition unaddressed may lead to a gout attack at the early stage of ketosis, and uric acid stones may form in the kidney.
Now you know the reason why many people attribute a risk factor associated with the keto diet and kidney stones.
Who Can Benefit From A Low
Uric acid crystals can form kidney stones or cause gout if they build up in the joints and tendons.
According to the American Academy of Family Physicians, a low-purine diet can lower the levels of uric acid in the bloodstream and reduce the risk of severe complications.
People with high levels of uric acid in the blood have a condition called hyperuricemia, and a low-purine diet can help.
Foods that contain high levels of purines include:
- wild game, such as veal, venison, and duck
- red meat
- some seafood, including tuna, sardines, anchovies, herring, mussels, codfish, scallops, trout, and haddock
- organ meat, such as liver, kidneys, and thymus glands, which are known as sweetbreads
Other foods and beverages can change how the body retains or eliminates uric acid.
A person should significantly limit or avoid the following foods to help the body process purines more effectively:
- High-fat foods: Fat holds uric acid in the kidneys, so a person should avoid fried foods, full-fat dairy products, rich desserts, and other high-fat items.
- Alcohol: Beer and whiskey are high in purines, but some research shows that all alcohol consumption can raise uric acid levels. Alcohol also causes dehydration, which hampers the bodyâs ability to flush out uric acid.
- Sweetened beverages: Fructose is an ingredient in many sweetened beverages, including fruit juices and sodas, and consuming too much puts a person at risk for gout.
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How Can Uric Acid Stones Be Prevented
You can help to prevent uric acid stones if you do the following:
- Drink at least three quarts of fluids daily water is best.
- Limit the amount of alcohol you drink.
- Achieve or maintain a healthy weight.
- Avoid crash dieting, which increases uric acid levels in the blood.
- Follow the Dietary Approaches to Stop Hypertension diet, which has been shown to reduce not only high blood pressure but also the risk of kidney stones.
Many patients may also need to take prescribed medications to prevent uric acid stones and keep them from coming back.
Last reviewed by a Cleveland Clinic medical professional on 11/03/2016.
References
Gout And Chronic Kidney Disease
Kidney disease and gout are both closely intertwined. A study in 2021 found that those with uncontrolled gout had a significantly increased risk of not only developing kidney disease but having more advanced kidney disease.
Its important to note that the kidneys are responsible for eliminating more than 70% of the uric acid in the body. Therefore, if a person has kidney disease it can be important to monitor uric acid levels and make dietary changes to prevent uric acid buildup.
That being said, research has shown that even without symptoms of gout or kidney stones, having high levels of uric acid when you have kidney disease can increase the progression of kidney disease.
From the National Health and Nutrition Examination Survey in 2008, 71% of people with gout also had kidney disease. And for those with severely high uric acid, 86% had kidney disease.
Its important to be aware of your uric acid level and talk with your doctor about how to best manage it.
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Idiopathic Uric Acid Nephrolithiasis
This largest group of patients has no identifiable secondary cause forthe development of uric acid stones. Clinical gout is not present, but itresembles primary gout in many aspects, for which reason the term âgoutydiathesisâ has historically been used . The similarities to goutinclude a persistently low urine pH, a reduced fractional excretion of uricacid, and varying degrees of hyperuricemia. However, individual values overlapconsiderably between this group and controls.
Persons with the metabolic syndrome share many characteristics withidiopathic uric acid stone formers, but they do not necessarily form uric acidstones. Nevertheless, in one study of unselected uric acid stones formers, morethan 50% were either overtly diabetic or had impaired glucose tolerance. In clinicalpractice, it is rare to encounter a uric acid stone former with absolutely nofeatures of the metabolic syndrome.
What Causes Uric Acid Stones
Uric acid stones form when the levels of uric acid in the urine is too high, and/or the urine is too acidic on a regular basis. High acidity in urine is linked to the following causes:
- Inherited problems in how the body processes uric acid or protein in the diet can increase the acid in urine. This can be seen in conditions such as gout, which is known for its high levels of uric acid in the blood and painful deposits of crystals in the joints.
- Uric acid can result from a diet high in purines, which are found especially in animal proteins such as beef, poultry, pork, eggs, and fish. The highest levels of purines are found in organ meats, such as liver and fish. Eating large amounts of animal proteins can cause uric acid to build up in the urine. The uric acid can settle and form a stone by itself or in combination with calcium. It is important to note that a persons diet alone is not the cause of uric acid stones. Other people might eat the same diet and not have any problems because they are not prone to developing uric acid stones.
- There is an increased risk of uric acid stones in those who are obese or diabetic.
- Patients on chemotherapy are prone to developing uric acid stones.
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How Is It Treated
To stop a gout attack, your doctor can give you a shot of corticosteroids or prescribe a large daily dose of one or more medicines. The doses will get smaller as your symptoms go away. Relief from a gout attack often begins within 24 hours if you start treatment right away.
To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better. But don’t take aspirin. It can make gout worse by raising the uric acid level in the blood.
To prevent future attacks, your doctor can prescribe a medicine to reduce uric acid buildup in your blood.
Paying attention to what you eat may help you manage your gout. Eat moderate amounts of a healthy mix of foods to control your weight and get the nutrients you need. Limit daily intake of meat, seafood, and alcohol . Drink plenty of water and other fluids.
Your Gout Flare May Come With An Unexpected Side Effect: Kidney Stones Here Are More Signs Your Kidney Stones Could Be Related To Gout And How To Treat Your Uric Acid Stones
Gout and kidney stones can both be incredibly painful conditions. They are both related to kidney function. But how are they related to each other? Can gout cause kidney stones, or can having kidney stones predispose you to gout?
Heres what you need to know if youre concerned about either of these conditions and how theyre connected.
Gout develops when the body has high levels of uric acid, a normal waste product. This is known as hyperuricemia. Uric acid is normally excreted through the body via the kidneys, but in some people, levels can remain high and uric acid can start to accumulate and crystallize in various joints. A gout attack can feel like a burning pain or a tingling sensation, depending on where the attack occurs. Regardless, the pain is, off the charts, completely intolerable, as CreakyJoints member Louise B. previously told us.
For people whose kidneys dont filter waste well, the excess uric acid can crystalize in the kidney and form a type of kidney stone known as a uric acid stone.
However, uric acid kidney stones are just one type of kidney stone. Other types of kidney stones are unrelated to gout and can develop from a build-up of other substances, such as calcium, struvite, or cystine chemicals your body gets rid of through the kidneys. Kidney stones can feel like a sharp, cramping pain in the back and side, according to the Urology Care Foundation.
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Ways To Reduce Your Risk Of Kidney Stones Forming
Please note this advice only applies to kidney stones in adults and not children.
Kidney Stone Diet Goals
The goals of the kidney stone diet really boil down to 4 distinct outcomes. Each of the kidney stone diet components works to get us to at least one of these goals.
A healthy kidney stone diet is different for everyone. Twenty-four hour urine tests will help you and your doctor determine which aspect of the diet is most important for you.
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A Concentration Of Acid/salt On A Ketogenic Diet Can Impact Gout
The concentration of the acid/salt is another contributory factor to gout and kidney stone formation during ketosis.
Think of soluble salt in water. As you add the salt to the water, it dissolves. But as you add more salt, a point will come when the salt no longer dissolves. Its at this point that we say the solution is fully saturated. If you continue to add more salt inside, the crystals will go to the bottom of the solution and precipitate.
Now imagine this occurring in your bloodstream. The undissolved uric acid crystals can accumulate over time and cause an inflammatory response. This mechanism is how gout takes place.
Eat A Moderate Amount Of Protein
A high protein diet will increase the urine calcium. In addition, high protein diets produce acid during metabolism. This acid is eventually excreted in our urine, which lowers urine pH and increases the risk of kidney stones. Similar to sodium, the extra calcium in urine from a high protein diet is taken from bone, putting them at risk.
For most people, a healthy amount of protein is: 0.8 grams protein / kilogram body weight. For example, a person who weighs 175 pounds should eat about 64 grams of protein per day . The right amount of protein for you might be different based on your body size, age, sex or nutrition status. Always ask your dietitian what is best for you.
Similar to sodium, most Americans eat much more protein than we need. The 0.8 grams per kilogram recommendation for people with kidney stones is the same amount recommended for healthy adults. Even for people who are vegetarian or vegan, it is fairly easy to eat enough protein.
Unsurprisingly, most of the protein in our diet comes from meat, poultry, fish and seafood. A 3 ounce portion of animal flesh has about 25 grams of protein in it. This is 40% of the protein goal for the entire day in our example of a 175 pound person. Pair that with protein from meat eaten at other meals and the small amount of protein found in nearly all foods. You can easily see how protein adds up quickly!
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Physiology Of Purines And Uric Acid/urate
In humans, uric acid is the end product of purine nucleotide metabolism.The formation of uric acid involves purine degradation to inosinic acid andhypoxanthine. The enzyme xanthine oxidase then converts hypoxanthine toxanthine and uric acid. While this is the final step in higher primates, mostmammals are able to convert uric acid to allantoin via uricase. Allantoin ishighly soluble without any known adverse effects on health. Recombinant uricase is in routine clinical use forsituations of anticipated severe hyperuricemia, such as chemotherapy inducedtumor lysis syndrome and the prevention of acute crystal-induced uric acidnephropathy . XOinhibitors are effective in reducing new uric acid formation, but accumulationof xanthine may result in acute xanthine nephropathy .
Knowing That Gout Can Lead To This Painful Complication Only Means That You Should Take Precautions And To Follow A Diet And Lifestyle That Makes This Development Less Likely For Example:
- Make hydration a priority. Drink plenty of water to avoid dehydration, especially when exercising, and allow the kidneys to flush out excess uric acid.
- Avoid alcohol, especially beer, as it contains purines which convert to uric acid in the body, while it also dehydrates the body, and decreases your bodys ability to excrete that acid.
- Stay away from sugary beverages as well as they can also increase purine levels.
- Avoid red meats, organ meats, shellfish and some seafood. All are high in purines.
- Get exercise and maintain a healthy weight. Obesity is a gout trigger and by combining eating a healthy low purine diet along with exercise, while following your doctors recommendations in this area, can really help decrease complications from gout.
A little caution and common sense go a long way toward preventing uric acid kidney stones, not to mention making a healthy life a reality. Check with your physician before starting any diet or exercise plan to be sure it is right for your needs.
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