M10.379

Clinical Causes: Chronic kidney disease or renal impairment leading to decreased elimination of uric acid from the body. Reduced kidney function causing uric acid to accumulate in the bloodstream. Use of certain medications that impair kidney function or increase uric acid levels. Dehydration, which reduces the kidneys' ability to filter uric acid effectively. Other underlying health issues such as high blood pressure or metabolic syndrome that affect kidney health.

Key Symptoms: Sudden and severe pain in the affected ankle or foot. Redness and warmth around the joint. Swelling and tenderness in the joint area. Possible skin over the joint appearing shiny or tight. Episodes often occur at night and may be accompanied by fever or chills. Repeated attacks can lead to joint damage and deformity if untreated.

Diagnosis Path: Medical history review focusing on kidney health and previous gout episodes. Physical examination of the affected joints to assess swelling, redness, and warmth. Blood tests measuring serum uric acid levels, with elevated levels supporting the diagnosis. Joint fluid analysis through aspiration to detect monosodium urate crystals, confirming gout. Assessment of kidney function through tests such as serum creatinine, estimated glomerular filtration rate (eGFR), and urinalysis.

Treatment Protocols: Anti-inflammatory medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine to relieve acute attacks. Rest, ice, and elevation of the affected joint to reduce swelling and pain. Long-term urate-lowering therapy, such as allopurinol or febuxostat, to prevent future attacks by decreasing uric acid production. Managing renal impairment through lifestyle modifications, medication adjustments, and treating underlying health conditions. Encouraging adequate hydration to help kidney filtration and facilitate uric acid removal. Dietary changes to reduce intake of purine-rich foods such as red meats, shellfish, and alcohol.