Gout and End Stage Kidney Disease

[RonZone]

So a couple of times over the last couple of months, I've experienced pain in my foot, around the big toe joint. My wife thinks it's gout. Is gout associated with Stage 5 Kidney disease?

[cs65 NKF Ambassador]

Oh, yes. Gout is an inflammation caused by buildup of uric acid, which can result from your kidneys not being able to filter like they used to. Talk to your nephrologist because there are meds to treat it. Also, watch what you eat, because overindulgence of certain foods like shellfish can lead to gout. Talk to your renal dietitian about this.

[RonZone in reply to cs65]

Hey thanks for the info. I was walking around with a very sore foot this past weekend. Thought it might be the cold weather and an old high school injury, but it went away in like a day or so and if it was the weather, should've acted up way before now. So uric acid. mmmm. have to read up on all that. I don't have a renal dietitian as of yet, they say they don't provide those until I've actually started dialysis later this summer. I'll do some googling around between now and my next doc appt in March and check into what foods might cause that flare up. Probably something I ate last week. Good to know that it's related, so I can add it to my growing list of questions for my doc. Thanks again. You guys are a wealth of knowledge on here.

[KidneyCoach NKF Ambassador in reply to RonZone]

You can request referral to renal dietitian before dialysis. Good news is many get relief with minimal flare ups after starting dialysis. Blessings

[RonZone in reply to KidneyCoach]

I'll ask again about the renal dietitian. Maybe it's that the insurance won't cover it until I'm actually on dialysis, that's why the dialysis company I'm looking to use said they don't provide one until folks are on dialysis.. I'll find out from my insurance company. Good to know that dialysis helps with this. I mean it wasn't that bad to deal with for a day or so but if it had lasted a couple of weeks or more, now that would've been difficult to deal with.

[KidneyCoach NKF Ambassador in reply to RonZone]

Insurance can be an issue and dialysis clinics don't offer dietitians until on dialysis which is why you need a direct referral from nephrologist not the clinic. Sounds like your future clinic is DaVita?? Don't request one through a clinic.

Blessings

[RonZone in reply to KidneyCoach]

Ah, referral from doc. I'll go that route. Thanks! Oh the clinic my doc is associated with is Fresenius. I didn't know until my last visit with the doc that docs are connected to certain clinics and that to change clinics would mean changing docs.

[htpi1543 in reply to RonZone]

Hey RonZone

Cs65 has a good advise for you to see your Nephro for gout

I also had a gout attack (right big toe) day before yesterday. My Nephro prescribed prednisone 20 mg. 3x daily. For 7 days

I took it for just one day and my gout and pain disappeared 95%

And I am feeling more energetic

I am stage 4 and energy is a problem. Normally I walk 1 mile a day, but today I could walk 2 miles without any problem

I think it is because of Prednisone

If prednisone can make me feel that good, I do not mind taking it forever. But I know that it must have some side effects issues

So my question to the members

Can anyone throw some light on pros and cons of Prednisone( steroid)?

I will highly appreciate it

Kind Regards

Sam

[RonZone in reply to htpi1543]

Sam, thanks for the info. I want to start walking once the weather get's a tad warmer and it stops raining so much here, and was worried about this toe thing making it where I could not walk, but since it cleared up after a couple of days all by itself, I'm happy to report, walking looks like it's back on the schedule. i did a bit of research and found out that it was the lamb I had at a greek restaurant that was the culprit. Who knew the little lamb would step on my toe so bad! No more lamb for me! I'm supposed to see my doc in march, I've added the prednisone to the list of questions I'll be asking, in case there's something else I eat that causes another flare up. This forum is full of good information. My list of questions for my doc has grown exponentially because of what I've ready here. He's not going to like seeing me come in with my list of topics to discuss!

[mingmiley in reply to htpi1543]

Prenisone used long time or in large dosages can cause Osteoporosis, and also for people with mental problem, like me, should not use Prenisone, for it will aggrevate the mental condition. The good news is nowaday they don't use P for anti-rejection med except for some.

[htpi1543 in reply to mingmiley]

I took prednisone for two days and stoped it. Gout was gone

Thanks for letting me know the side effects of prednisone

God bless

[rabbit01]

Yes it certainly is. I can share your pain as I had it last year. Really nasty. Who would have thought so much pain could be generated by some tiny crystals!

[RonZone in reply to rabbit01]

Yeah, I was walking around going "oh my toe, oh my toe, oh my toe, ever time I took a step, and getting my shoe off at the end of the day was rough. Thought I was going to have to cut it off (the shoe, not my toe), but finally made it. And two days later it was fine. Crystals, very strange. Hate to hear you had this too. I'll definitely do some research on how to avoid this surprise issue that i wasn't expecting. My doc never said anything about watching out for gout.

[SadMad]

I take 200 mg of Allopurinol to try to prevent gout and colchicine as needed when I have an attack which is brutal. Luckily I haven't had a gout attack in my foot in a while but think am having some in my left knee which hurts at night and when walking I have to use a crutch. I usually rub my knee and/or knees down with generic Ben-Gay and take a tylenol and if bad a colchicine and can get through the night. It is so hard not to take an NSAID which would be so much better for the pain but is so bad for the kidneys.

[RonZone in reply to SadMad]

Hey, thanks for this info. I'll ask my doc about Allourinol and colchicine. I've not had it in my knee yet, that doesn't sound fun. Are you on dialysis yet? I'm supposed to start PD in the next few months I think.

[SadMad in reply to RonZone]

No I am not on dialysis yet but am getting an AV fistula in my arm on Monday as I cannot do PD dialysis. I am stage 4 so could be several years before I actually have to start dialysis, am working on getting on transplant list but now have to go to the urologist as I have a suspicious solid mass on my right kidney which could be renal cell carcinoma. I started having what felt like a gout attack last night and took 2 colchicines and that took care of it because today I am fine just tired.

[RonZone in reply to SadMad]

So if I may ask, if you won't be starting dialysis for a few years, why would you be getting the fistula now? And actually I just assumed I could do PD dialysis. Not sure what the requirements are. I'm supposed to see my doc in March. I guess he'll tell me what I need to do to qualify for PD and if I qualify or not. I hope the procedure to put the fistula in your arm goes very smooth. You can tell me about it once it's over so I'll know what to expect when the time comes. I'm at stage 5, 14% at last report a month ago.

[SadMad]

Well it takes a couple of months for fistula to heal and I hope I have a few years until dialysis with the way my renal function is going right now but you never know and rather have fistula ready than have a catheter in chest and fistula later.

[RonZone in reply to SadMad]

Ahh I see. yeah, I don't know much about the catheter in the chest version, but it does sound like the move unfavorable choice, so understand the need to be ready. I'll be watching for a report on how the procedure goes. Good luck!

[ILMA54]

I am stage 5 (GFR 11). had more issues with gout when I was stage 3. Usually, a prescribed pain reliever and colchicine did the trick. I know it sounds crazy, but a can of cherry pie filling also helped.

Since starting on 300 mg allopurinol/day (just reduced to 150/day, I have not had a gout attack (10+ yrs).

[RonZone in reply to ILMA54]

I'll keep a can of cherry pie filling in the pantry and try it! When will you start dialysis? Or have you started already?

[ILMA54 in reply to RonZone]

I have not started dialysis yet. Typically, they start people when they get to a GFR of 10 or below, but they also factor in how you feel. Even at 11, I still feel very good, though I have certainly lost a great deal of strength and stamina over the last year.

That said, I was within 15 seconds of my time the previous year for my maximal heart rate stress test.

[RonZone]

Yeah, at 13% I still feel fine, just, as you say, lack of strength and stamina. I get winded easily and can fall asleep at the drop of a hat if I just close my eyes for a few minutes (I have to be careful doing that at work, ha!) I've been working on sticking to a very low sodium, low potassium, low phosphorous and very little meat diet. Hopefully that will keep dialysis at bay for a few more months. Once it warms up ( oh I get cold really easily) I'll get outside and get more exercise working in the yard and stuff, which I hope will also help build my energy levels up a bit as well. I haven't asked about a stress test. That's not a bad idea.

[Jayhawker]

RonZone,

I used to be cold all the time too. My nephrologist said that that was due to my severe anemia. Now that my anemia is under treatment I rarely am cold like that.

Jayhawker

[RonZone in reply to Jayhawker]

Well I hope my doc has me some good treatment in mind when i go to see him March 19th! He's in for a surprise. I normally go to my appt every year, and just listen to what he has to say and then pay my co-pay and leave. This appt will be very different. After listening to things you and others have said on here, and going through Kidneyschool.org modules, I've got a list of about 20 questions to ask him when I go to this next appt. He may not like me taking up so much of his time, but hey, it's my time this next appt to get some answers. I think I'll call his office and let them know I'm going to need a bit more time this appt than I've taken up to now. Time to get into this stuff. Thanks so much for all the information you've posted and for your replies. It's very much appreciated.

[Jayhawker in reply to RonZone]

If you have a patient portal you could upload your questions before your appointment.

Jayhawker

[RonZone in reply to Jayhawker]

mmmm. not sure they have a "patient portal". I'll call the doc's office and see. Good suggestion!

[Oceanviewed]

I used to get gout in my big toe from time to time then I woke up one morning with it in both feet. Was like walking on ground glass. Since then I have been on Uloric one a day and have not had a problem since. Hope you get something that works as that pain is a showstopper