Analysis of urolithiasis in patients with gout and hyperuricemia using ultrasonography

Abstract

The number of patients with gout and hyperuricemia is increasing in Japan. Urolithiasis is one of the important complications in this disease and early diagnosis of urolithiasis is necessary in disease management. Therefore, we expected to find an exact incidence of urolithiasis in Japanese gouty and hyperuricemic patients in our study. We examined 208 patients using ultrasonography (US) of the abdomen at our hospital (171 primary gout and 37 asymptomatic hyperuricemia). We examined the incidence of urolithiasis in US of the abdomen, past history and urine occult blood reaction in gouty and hyperuricemic patients. We also examined the duration of the current illness. The total number of ‘positive findings’ in US of the abdomen was 64 among 208 cases (30.8%). For these 64 with ‘positive findings’, 51.6% had ‘calcification’ or ‘stone formation’ in bilateral kidneys and 48.4% showed ‘positive findings’ before the onset of gouty arthritis. Among the 208 cases, 16.3% had a history of urolithiasis. Of the 59 cases with ‘stone formation’ among the 64 with ‘positive findings’ in US of the abdomen, 10.2% showed a positive urine occult blood reaction. The frequency of detecting a ‘positive findings’ was evidently proportional to the detection of this illness. In conclusion, the incidence of urolithiasis in gouty and hyperuricemic patients was examined by US of the abdomen. The value of this diagnostic modality was highly appreciated in this instance. The following were suggested as important approaches for the management of gouty or hyperuricemic patients: correction of the serum uric acid levels, early diagnoses of urolithiasis by US of the abdomen, proper alkalization of urine and sufficient diuresis.