Other conditions

Often beside it, without a number

Kidney disease, heart risk, and other joint problems show up more often alongside gout. High blood pressure is part of that picture. So are kidney stones when urate is high; see Kidney stones and gout. “More often” is as quantitative as this page gets. There is no rate here, and no list that says these problems are inevitable.

High urate is not the same thing as gout. NIAMS notes that many people with high urate never develop gout. Having one of the conditions on this page does not diagnose gout, and having gout does not diagnose the others.

Kidneys

Kidneys are how most urate leaves the body. Kidney disease changes the conversation about which medicines are even possible, including medicines for a flare and medicines that lower urate. The 2020 ACR guideline still names allopurinol as the usual first urate-lowering medicine, including when chronic kidney disease is present. Usual is not a promise that you can take it. Kidney function belongs in the visit.

This page will not tell you that a medicine is safe for your kidneys, and it will not tell you to avoid one. That is the clinician’s call. Names, still without doses, are on Medicines, by name.

Heart risk

High blood pressure and heart disease show up more often in people with gout. That is a reason to stay in regular care. It is not a risk score this site can calculate, and it is not a reason to stop a heart medicine because you read about gout.

Food and weight still matter, including for the heart and kidneys. NIAMS describes the DASH eating pattern, especially for people who also have high blood pressure, as an ordinary healthy pattern. It is not a substitute for urate-lowering medicine when that medicine is needed. Food, as an adjunct only, is on Food and drink.

Other joint problems

A person can have gout and another joint problem at the same time. A new hot, swollen joint can also be an infection, which can look the same at the start. Already having gout, or already having some other arthritis, does not settle the next painful joint.

This page will not sort lumps, stiffness, or a single sore joint into categories for you. Tophi, a flare, and long-term joint damage are related and are not the same problem. That distinction is on What gout is. The diagnosis still belongs with a clinician, as on How gout is diagnosed. The most common crystal look-alike, CPPD, is on Pseudogout and gout.

Medicines you take for something else

Some prescribed medicines are tied to higher urate. NIAMS names certain diuretics and low-dose aspirin among them. That is not a reason to stop them. They are often there for blood pressure, the heart, or the kidneys. Any change belongs with the clinician who prescribed them.

Do not drop a medicine in the middle of a flare, and do not drop one because a gout page mentioned the name. Tell the clinician the names of what you take. Ask what to be careful with. A question list, which is not advice, is on Questions to ask.

The clinician who knows you

Bring the whole list: kidneys, blood pressure, heart disease, other joint problems, pregnancy if it applies, and every medicine. This page cannot tell you which problem matters most, or what to change first.