Delbarba Elisa, Terlizzi Vincenzo, Dallera Nadia, Izzi Claudia, Scolari Francesco
G Ital Nefrol. 2016;33(S68).
Already known to ancient Egyptians, gout is one of the first diseases which have been described as a clinical entity. To date, gout is the most common form of inflammatory arthritis. Gout is defined by the deposition of monosodium urate crystals within tissues, causing episodes of acute arthritis and the development of tophi, nephrolithiasis, and urate nephropathy. Hyperuricemia, i.e. levels of serum uric acid above 6.8 mg / dL(404mol/L), is a condition necessary, yet not sufficient for gout to develop. The increasing incidence of risk factors such as hypertension, obesity, and renal failure together with an ever-growing life expectancy has led in recent decades to a significant increase in gout prevalence, which has more than doubled when compared to the 1960s. This article addresses the issue of gout by highlighting the role played by the kidneys in uric acid homeostasis; the clinical effect of crystal deposition in tissues, including the kidney; the more recent guidelines on diagnosis and management strategies, with special regard to the use of old and new drugs in renal patients.
痛风早已为古埃及人所知,是最早被描述为临床实体的疾病之一。迄今为止,痛风是炎症性关节炎最常见的形式。痛风的定义是组织内尿酸钠晶体沉积,导致急性关节炎发作以及痛风石、肾结石和尿酸肾病的发生。高尿酸血症,即血清尿酸水平高于6.8毫克/分升(404微摩尔/升),是痛风发生的必要条件,但并不充分。近几十年来,高血压、肥胖和肾衰竭等危险因素的发病率不断上升,加上预期寿命不断延长,导致痛风患病率显著增加,与20世纪60年代相比增加了一倍多。本文通过强调肾脏在尿酸稳态中的作用、晶体在包括肾脏在内的组织中沉积的临床影响、最新的诊断和管理策略指南,特别是在肾病患者中使用新旧药物的情况,来探讨痛风问题。