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hi , ive been have severe pain in my feet for 2years, and recently been diagnoised with gout! had a bad attack in right thumb joint!! also Big toes and top of left foot! uric acid level at time of thumb attack was 11! i was given a zip pack of predinsone and it went down and pain was relieved until i was done with drugs , i also have a kidney transplant, i take neoral for anti rejeaction and ive read that that could cause gout, i also take 10mg of lasix everyday also! i m going to see my kidney doc for advice, im worried about hurting my kidneys!! so any advice would be hepful!! thanks in advance!!! Dan
Hi dj. There are many others more qualified to reply than me; I was clueless 3 months ago, but I'll share with you what GP and others on this site have taught me. I also have a transplant kidney, have had gout for 2 years, and am on Neoral.
– yes, Neoral reduces ability to excrete UA. So does reduced kidney function.
– you must reduce your UA. The only way to do it is with medicine. You need to get on Allopurinol right away. UA needs to get below 6.0 (the level above which UA crystallizes). Your doctor will likely start you on 150 mg to ensure you are allergic, but they need to bump you up to 300 mg as soon as they know you can tolerate it. Most people can. (I am a rare one that couldn't and am on Uloric instead- a more expensive- not necessarily better drug, but an option you should know about in case you have problems with Allopurinol– the only other option for those of us with kidney transplants, by the way).
– you need to see a rheumatologist. they are the gout experts. Your nephrologist is your kidney expert, but not gout. If he was, he would have been treating your UA levels perhaps as long as 2 years ago.
– I've also been given high does prednisone for gout flare ups and it helped temporarily. Ask about colchicine- a highly effective gout medicine, safe at lower doses, for kidney recipients.
-prednisone, colchicine, and nsaids (ibuprofen, etc) (which kidney transplant patients cannot take), are all good for short term pain relief, but a common problem with gout is doctors treat the symptom, but not the cause– high UA levels.
– you should also drink a lot of water all day, every day, to help excrete uric acid. you could also read about gout diets on this web site and reduce things like alcohol, red meat, shell fish. But don't be lured into thinking you can manage this with diet or herbal remedies, with levels of 11 and your kidney situation, you must get on Allopurinol. Diet alone can only reduce UA levels by up to about 1.0. You need to get from 11.0 down to at least below 6.
Hope that helps. Keep us posted.
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