Renal Changes in Gout

Renal Biopsy in Gout

“…Most authors agree on the final picture of gross tubular atrophy and (Schnitker and Richter, 1936;Brown and Mallory, 1950;Modern and Meister, 1952;Fineberg and Altschul, 1956;Lichtenstein et al, 1956). The part played by urate deposition and tubular obstruction in the production of this picture has been the subject of controversy.…”

“…In this context, the phrase " benign gouty nephrosis " has been used (Sokoloff, 1957). Brown and Mallory (1950), however, thought that their necropsy findings supported the view that the main cause of renal failure in gout is tubular blockage by uric acid. There is no doubt that massive excretion of uric acid, such as follows the irradiation of leukaemic patients, can cause tubular obstruction and even fatal renal insufficiency (Greenbaum and Hope Stone, 1959), but it is uncertain whether this bears any relation to the pathogenesis of the gouty kidney.…”

Malignant Gout with Tophaceous Small Intestine and Megaloblastic Anaemia

“…At necropsy, the kidneys are found to be shrunken, scarred, and laden with urate deposits in the medulla-these conforming to the shape, direction, and position of the collecting tubules. The inflammation and foreign-body reaction to the crystals has often destroyed the tubular structure and caused nephrosclerosis (Brown and Mallory, 1950).…”

Die Gicht

“…Da die Steinbildungen den übrigen Manifestationen um Jahre vorauslaufen können, muß an die Hyperurikäm ie gedacht werden, auch unter dem Gesichtspunkt, daß die Uratsteine oft sekundär Kalk inkrustieren. -Bei den eigentlichen renalen Komplikationen kon- 16 [112,113] (Dem onstration einer Gichtnephrose im M ikrophoto gramm). Diese interstitiellen Veränderungen beginnen früh, führen entsprechend oft zu milden Albuminurien und Funktionseinschrän kungen, sind aber nur langsam progredient und prognostisch nicht ungünstig, wenn es nicht zu bakteriellen Superinfektionen m it floriden Pyelonephritiden kom m t [112].…”