CLINICAL FEATURES OF SONOGRAPHY-DIAGNOSED GOUTY NEPHROPATHY: ANALYSIS OF 151 CASES IN A MEDICAL CENTER

摘要

Background: Gout is a disorder of purine metabolism or renal excretion of uric acid, and frequently involves the kidney. Sonographic abnormalities are specific findings suggestive of renal tissue damage. We aimed to investigate clinical manifestations of gouty nephropathy, evaluate renal function and find out factors contributing to renal failure. Methods: We retrospectively enrolled 151 gouty patients with sonographic evidence of gouty nephropathy between May 1998 and October 2005. Demographic data, kidney size by sonography, biochemical data including blood urea nitrogen and creatinine, urinalysis report, and comorbidities of each patient were collected. Results: Among the 151 gouty nephropathy patients enrolled, 87.4% (N = 132) were men. About 56% of the patients had hematuria and 30% had proteinuria. We found that 81.4% of the patients had marked renal function impairment (chronic kidney disease, CKD, Stages 3-5). Normal kidney size was observed in 77.5% of the subjects, among which 76% were at CKD Stages 3-5 according to their renal function. Proteinuria was detected more frequently as renal failure progressed (p = 0.026). Hypertension, which accounted for 48.3% of our patients, was noted to increase proportionally with advanced kidney failure. In multivariate regression analysis, patient age was found to be the sole independent associate of renal function. Conclusion: Most gouty patients with sonographic abnormalities were characterized by impaired renal function. With CKD progressions, incidence of both proteinuria and hypertension were also high. Patient age was an important contributing factor of renal function impairment in gouty nephropathy.