Many gout patients will find that they have kidney stones or [small crystals] during physical examination. Before starting uric acid reduction treatment, doctors will also open kidney B-ultrasound to determine whether there are kidney stones.
So is there a what relationship between stones and gout?
One in five gout suffers from kidney stones.
Statistics show that about 20% of patients with primary gout have kidney stones at the same time, and the main component of these kidney stones is uric acid crystals.
About 70% of uric acid in the body is excreted by the kidney. Even for people who do not suffer from gout, the concentration of uric acid in the kidney (renal tubules) is relatively high. However, the concentration of uric acid in the kidney of patients with gout and high uric acid is often higher than that of ordinary people. Excessive concentration of uric acid is easy to precipitate and form uric acid crystals, thus forming uric acid kidney stones.
At the same time, uric acid will also increase the formation of calculi such as calcium oxalate. Therefore, kidney calculi of patients with gout and hyperuric acid may often be mixed, including uric acid and calcium oxalate.
Gallstones have little to do with gout and hyperuricemia.
Many patients will ask: Is my gallstones related to high uric acid?
Uric acid produced by the human body is mainly excreted by the kidney, and another part is excreted through the intestinal tract. Uric acid excreted through the biliary tract is very small. The main component of gallstones is generally cholesterol or bile pigment, and there are few uric acid gallstones, so the relationship between gallstones and high uric acid is not big.
Benzbromarone is usually not used for kidney stones.
Drugs for lowering uric acid mainly include benzbromarone, which increases uric acid excretion, and allopurinol and febustat, which reduce uric acid production.
One of the main contraindications of benzbromarone is kidney stones. Its uric acid reduction effect is mainly realized by increasing the excretion of uric acid by the kidney, thus increasing the possibility of kidney stones. If kidney stones already exist, benzbromarone is generally not applicable.
Some patients may ask, if it is not uric acid kidney stones, can benzbromarone be used?
In fact, it is not easy to judge the composition of kidney stones by general imaging examination, and uric acid in urine will also promote the generation of other types of stones.
Therefore, whether it is uric acid kidney stones or not, if there are kidney stones, benzbromarone will not be given priority to reducing uric acid.
Sodium Bicarbonate + Benzbromarone to Prevent Kidney Calculi
In order to determine whether there are kidney stones, doctors will require kidney B-ultrasound before choosing uric acid lowering drugs.
If kidney B-ultrasound does not find kidney stones, benzbromarone can be considered to reduce uric acid and gout.
Moreover, once benzbromarone is selected, it should be taken in conjunction with drugs that alkalize urine such as sodium bicarbonate tablets. The main function of sodium bicarbonate tablets is to alkalize urine, help uric acid discharge and reduce the occurrence of kidney stones.
If kidney stones already exist, such treatment shall be carried out.
Gout patients who already have kidney stones should consult urologists first and determine whether surgery is needed according to the size of the stones. For gout patients who do not need special treatment such as surgery, they can take sodium potassium hydrogen citrate granules under the guidance of doctors, and pay attention to drinking more water at the same time, so that some kidney stones can dissolve and disappear again.