Korean Journal of Nephrology 1991;10(4):518-525.

통풍과 고 요산혈증이 신기능에 미치는 영향

성건형 , 정성훈 , 강경원 , 김정호 , 김지훈 , 박찬현 , 강종명 , 박한철

Abstract

We analyzed 54 patients who have sufferred from over 10 years to evaluate the cause of renal failure in gouty nephropathy. The results are as follow; 1) Incidence of proteinuria was higher in patients with a low glomerular filtration rates, being 100% in those with GFR below 10ml/min, 77.3% with GFR between 10-30ml/min, 85.7% with GRF between 30 -50ml/min, 0% with GFR above 50 ml/min. 2) There was a modest correlation between the inci- dence of proteinuria and age. Proteinuria occurred in 0% of those aged below 40 years, 25% of those in 4th decades, 64.3% in 5th decades, 58. 8% in 6th decades and 70% in 7th decades. 3) Tophi were more frequently observed in subjects with low GFR, being 40% in those with GFR below 10 ml/min, 27.3% with GFR 10-30ml/min, 28.6% with GFR 30-50ml/min, 42.9% with GFR 50-80ml/min and 0% with GRF above 80 ml/min. 4) U urate V greater than 800 ug/min (excessive U urate V) occurred more frequently in those with a plasma urate concentration of 9 mg/100 ml or above. 5) The incidence of excessive U urate V was greater in the younger age groups and proteinuria did not occur frequently in excessive U urate V group. 6) Tophi were more frequent in patients with a low glomerular filtration rate, being 20% with GFR below 10mg/min, 22.7%' with GFR between 10-30ml/min, 14.3 % with GFR between 30-80ml/min, and 0% with GFR above 80 ml/min. 7) Hyperuricemia alone did not adversely affect the renal function in gout and following factors correlate with nephropathy in gout; cardiovascular disease, notably hypertension and atherosclerosis, nephrocal- cinosis and urinary tract infection (UTI). 8) The predisposing factors of gouty nephropathy were hypertension, atherosclerosis, UTI, and nephrocal- cinosis and we could not find a predisposing factor in 2 cases. The mean interval from first gout attack to gouty nephropathy was 15.4 years. 9) In comparision with gouty nephropathy and secon- dary gout, male was predominant in each group. Mean age of gouty nephropathy patients was 56.1 years and that of secondary gout was 42 years. The number of attack and ESR were higher in gouty nephropathy and tophi were nor found in secondary gout. In conclusion, hyperurieemia alone did not affect the renal function in gout patients. Age, hypertention, ather- osclerosis, infection, nephrocalcinosis, and intrinsic renal diseases were the predisposing factors to the aggrevation of renal function in gout patients.