Gout is much more frequent in patients with chronic renal failure than in the general population. The explanation lies in the body's control of serum uric acid levels. Uric acid normally is excreted in the urine, but when kidney function decreases, uric acid excretion decreases and, as a result, blood levels tend to rise. An elevation above 6 mg per dl tends to cause precipitation of uric acid in joints (causing gout) and also in the kidneys, sometimes leading to a uric acid kidney stone.
In addition, diuretics such as thiazides and furosemide, which people with kidney disease often use, increase uric acid levels and make gout more likely.
Gout also may be the cause of kidney disease. High uric acid levels (over 13 mg per dl in men and over 10 mg per dl in women) can lead to chronic renal damage.
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