1 out of 10 people with Chronic Kidney Disease (CKD) have gout, and up to 20% of people with gout have mild to moderate kidney disease. CKD is known to be the third most common risk factor for gout. Gout and CKD coexist frequently, since both conditions are affected by high levels of uric acid in the body.
The body pulls out the vitamins, minerals, and nutrients from the foods and drinks you consume, and the kidneys remove the waste products of the body. One of those waste products is uric acid, which comes from the breaking down of purines. Purines are found in certain foods. Uric acid moves through the blood into the kidneys, where the kidneys add it to the urine, so it can leave the body.
However, when the levels of uric acid get too high, it can build up in the blood and cause gout. High levels of uric acid can happen when the body makes too much uric acid, and/or the kidneys can’t filter uric acid into your urine. Hence, if you have kidney disease, you must check in with your medical provider for gout.
The correlation between kidney disease and gout
Most uric acid dissolves in the blood and passes through the kidneys in the form of urine. However, when kidneys don’t function as they used to, uric acid can remain in the body for too long and can crystallize, which can then lead to gout. These crystals can damage and scar as they pass through the kidneys, contributing to kidney disease and kidney failure over time. They can accumulate in the joints, outer warm, and the skin near the joints. Some people with hyperuricemia-- high concentrations of uric acid levels in the blood – do not develop gout. Even when they do, they can go for years without showing any symptoms.
Gout Risk Factors
Among the factors that affect your uric acid level include diet, alcohol consumption, weight, existing conditions, medications, age, and gender. Frequent consumption of foods that are high in purines such as red meat, liver, kidney, pancreas, and thymus (collectively known as sweetbreads) can also cause gout. Several studies showed alcohol consumption as a major risk factor for gout, with beer having the highest purine content. Excessive weight can cause the body to release more uric acid, with overweight people being 85% more likely to have hyperuricemia than those with a healthy body mass index (BMI).
Diseases such as obesity, kidney disease, diabetes, and heart diseases can increase your risk of having gout. Meanwhile, taking medications such as aspirin, angiotensin-converting enzyme (ACE) inhibitors and beta-blockers elevates your risk of developing gout. Women have lower uric acid levels, making men more prone to developing gout at an early age, between ages 30 and 50.
Not all people with a high uric acid level develop gout, and those who have gout, may not necessarily manifest symptoms. Those who have a gout episode can have a very painful gout attack that can happen suddenly, and mostly overnight. A gout attack can last a week or two, where some can experience frequent hourly attacks, while others can go years between gout episodes. Among the symptoms include:
- Swelling in and around the affected joint and red, shiny skin over the affected area
- Peeling, itchy and flaky skin as the swelling goes down
- Hot and very tender feeling in the joints where it can come to the point of being unbearable to touch
Gout Foods to Avoid
Reducing foods rich in purine can help you manage your gout or prevent the risk of developing gout. While a great gout diet cannot entirely prevent attacks, it can help you reach a healthy weight, stick to great eating habits, and manage food with purines. Although people susceptible to gout should generally avoid food high in purines, eating vegetables high in purine doesn’t trigger gout attacks.
Here are foods you need to limit in your diet:
1.) Sweetbreads and organ meats
These can include the liver, kidney, thymus, and pancreas.
2.) Red meat
Observe serving sizes of red meats such as beef, lamb, and pork.
Eating moderate portions of fish can be a part of your diet. However, some types of seafood including anchovies, herring, trout, mackerel, haddock, shellfish, sardines, and tuna have higher purines than other types.
Beer has the highest purine content, so try to avoid drinking to prevent gout attacks or avoid alcohol altogether. The body may prioritize getting rid of alcohol over uric acid, where the latter can accumulate and crystallize.
5.) Sugary foods and beverages
Although they are not high in purines, these drinks can increase uric acid levels as they accelerate cellular processes.
Gout Diet Foods You Can Eat
Although gout diet sounds limiting, you can have a lot of options, including:
All fruits are great for gout, such as berries. Dark berries have anthocyanins, anti-inflammatory plant pigments, that can prevent attacks by minimizing uric acid levels and reducing inflammation. You can eat one-half to a cup of dark berries a day or drink cherry juice.
All vegetables are generally fine. These can include potatoes, peas, mushrooms, eggplants, and dark green leafy vegetables. Legumes are good too, including beans, soybeans, and lentils. However, if you have CKD, you might want to watch out for potatoes as they can increase your potassium level.
3.) Nuts and grains
All nuts and seeds are great as well as grains such as oats, brown rice, and barley.
4.) Poultry and Dairy products
5.) Plant-based meat alternatives
Instead of eating red meat, consider consuming plant-based alternatives for your protein. These alternatives can include tofu, tempeh, beans, and seitan. This blog article talks more about protein substitutes for CKD.
Lifestyle Changes to Avoid Gout Attacks
Besides avoiding following a gout-friendly diet, tweaking your lifestyle can also help prevent gout development or attacks. These can include:
1.) Weight management
Excess weight can make you insulin resistant, where the body can’t use insulin properly to remove sugar from the blood. Being resistant to insulin can increase the levels of uric acid in the body. This is not to say to follow a crash diet, as losing weight rapidly by eating less can actually increase the risk of gout episodes.
Working out can help maintain a healthy weight and keep uric acid levels low.
3.) Drinking water
Staying hydrated can help the body get rid of excess uric acid from the flood, flushing it out in the urine. You may need to watch out for your fluid intake though if you have CKD. Check your fluid requirement with your primary healthcare provider.
The Bottom line
People with CKD are prone to developing gout and are typically unaware of the risk. When left untreated, gout can worsen kidney conditions and can lead to serious health concerns. A gout-friendly diet can help relieve attacks but does not actually cure gout. Try to avoid gout triggers such as organ meats, game meats, fish, sugary beverages, and alcohol. Consuming foods low in uric acid, which would include fruits, vegetables, whole grains, and low-fat dairy products, may help prevent your risk of gout episode.
Always seek the guidance of your primary healthcare provider if you suspect gout, before taking any medication, so you can further protect your kidneys.
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