A cross-sectional study of 502 patients found a diffuse hyperechoic kidney medulla pattern in patients with severe gout.

Abstract:

:We have previously shown that ultrasonography can detect hyperechogenic crystal deposits in the kidney medulla of patients with gout. In this cross-sectional study we investigated the frequency and clinical correlates of hyperechogenic kidney medulla in 502 consecutive primary consultants for gout (ACR/EULAR criteria) at the Vien Gut medical center in Ho Chi Minh City, Vietnam. None of these patients received urate-lowering drugs. Kidney medulla echogenicity on B-mode ultrasonography was compared to that of the kidney cortex. Overall, 36% patients showed a hyperechoic pattern of Malpighi pyramids. On univariate analysis, the pattern was significantly associated with age, estimated gout duration, steroid-dependency, clinical tophi, urate arthropathy, double contour thickness at the scanned joints, coronary heart disease, arterial hypertension, hyperuricemia, proteinuria, leukocyturia, and decreased estimated glomerular filtration rate. On multivariable analysis, the hyperechoic pattern was associated with estimated disease duration, clinical tophi, urate arthropathy, double contour thickness and decreased estimated glomerular filtration rate. No hyperechoic pattern was observed in 515 consecutive consultants without gout. Thus, hyperechoic kidney medulla was frequently demonstrated in Vietnamese patients with tophaceous gout and associated with features of tubulointerstitial nephritis. This finding revives the hypothesis of microcrystalline nephropathy of gout, predominantly seen in untreated gouty patients, which could be an important target for urate-lowering therapy.

journal_name

Kidney Int

journal_title

Kidney international

authors

Bardin T,Nguyen QD,Tran KM,Le NH,Do MD,Richette P,Letavernier E,Correas JM,Resche-Rigon M

doi

10.1016/j.kint.2020.08.024

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

218-226

issue

1

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(20)31068-1

journal_volume

99

pub_type

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