Gout - Complications

Complications

Gout rarely poses a long-term health threat if properly treated. It does, however, remain a source of short-term pain and incapacity for thousands of Americans.

Pain and Disability

Left untreated, gout can develop into a painful and disabling chronic disorder. Persistent gout can destroy cartilage and bone, causing irreversible joint deformities and loss of motion. Tophi can grow to the size of handballs and can destroy bone and cartilage in the joints, similar to the process in rheumatoid arthritis. If they lodge in the spine, tophi can cause serious damage including compression, although this is very rare. In extreme cases, joint destruction results in complete disability.

Kidney Conditions

Kidney Stones. Kidney stones occur in10 -40% of gout patients, and can occur at any time after the development of hyperuricemia. Although the stones are usually composed of uric acid, they may also be mixed with other materials. A 2003 study showed that although a current diagnosis of gout doubles the risk of kidney stones, a history of gout does not increase kidney stone risk. Therefore, reducing gout risk factors with dietary and other lifestyle changes may reduce the likelihood of stone formation.

Kidney stones result when urine becomes too concentrated and substances in the urine crystalize to form stones. Symptoms arise when the stones begin to move down the ureter causing intense pain. Kidney stones may form in the pelvis or calyces of the kidney or in the ureter.

Kidney Disease. About 25% of patients with chronic hyperuricemia develop progressive kidney disease, which sometimes ends in kidney failure. It should be noted, however, that many experts believe that chronic hyperuricemia is unlikely to be a common cause of kidney disease. In most cases, the kidney disease comes first and causes high concentrations of uric acid.

Gout and Heart Disease

Gout often accompanies both risk factors for heart disease and heart disease itself. It is found in higher rates in people with obesity, high blood pressure, coronary artery disease, and congestive heart failure. Hyperuricemia, in fact, has been associated with a higher risk of death from heart conditions. One 2001 study reported that disease activity in gout may even contribute to unhealthy cholesterol and lipid levels. Some interesting evidence, however, suggests that hyperuricemia may occur as a response to inflammatory damage that occurs with heart disease and may even be protective.

Click the icon to see an image of coronary artery blockage.

Other Medical Conditions Associated with Gout

The following are some conditions that are associated with long-term gout:

• Cataracts
• Dry eye syndrome
• Complications in the lungs (in rare cases, uric acid crystals occur in the lungs)