Hello from Australia

This is the forum for the Kidney Patient Guide. We welcome feedback about the site and any information that may be of use or interest to other visitors.

IMPORTANT NOTE: This forum is not for queries that would otherwise be addressed to a doctor. If you have a question about your condition or treatment please consult your renal unit or doctor. We do not have any editorial or medical resources to answer individual queries.

Moderator: administrator

Hello from Australia

Postby Steve Emery » Sun May 23, 2004 10:32 am

Hello my name is Steve, 40 and I used to live in the UK but emigreted to Australia with my family 7 years age.
I found this site by accident after trying to find out about Gout.
I feel very lucky just having gout and feel quite guilty after reading about all the seriousness of the other peoples illneses. Good luck to everyone.

I have had gout for about 20 years on and off, it started in my big toe and has gone everywhere the last was Burcitis in my elbow.
I have a enzime deficiency in my kidneys and this is why I get gout or this is what the UK doctor told me.
I have not been taking regular medication but I think now I will have to start as it is getting worse. I did try Allupurinol at first but this did not seem to work very well. I have taken Indocid as a sepositry but these made me ill so at the moment I take nothing and just let it run its course.
I always have gout somewhere usually not to bad but I am awear of it all the time.

My Brother also has gout and he is on Allupurinol all the time. He still gets regular attacks and that is one of the other reasons I have not taken it regularly I'm not sure it will work.

Thanks for your time in reading this any feed back would be greatfully recieved.

Steve
Steve Emery
 
Posts: 2
Joined: Tue May 18, 2004 11:09 am
Location: Australia

gout & Allopurinol

Postby Cheryl in CT » Tue May 25, 2004 12:42 pm

Hi, Steve -

I hope you don't mind, but I'm going to re-post a reply I sent to someone with similar questions a long time ago. If it helps, I'm glad...

While I have never had gout myself (not that I'm complaining...) I have read a fair amount about it while doing research on renal disease. Since patients with gout generally have symptoms of hypertension and impaired renal function, as well, it all seems to go together. The development of Allopurinol for controlling hyperuricemia (increased serum uric acid concentration) and reducing serum urate concentrations to fend off gout attacks seems to have been a major boon for kidney patients. I hope you don’t mind if that this is a rather long message about the two. You may already know this stuff, but perhaps it will help others who also are facing the same issues.

Uric acid itself is an end product – basically a waste product of purine metabolism. Alcohol and protein and purine-rich foods (like organ meats, bacon, salmon, certain shellfish and turkey) increase the uric acid levels in the body, Since human beings lack the enzyme uricase, which breaks uric acid down into a more water-soluble waste product (allantoin), uric acid tends to accumulate in the body. Eventually, some 65-75% of the uric acid produced is excreted by the kidneys, with the rest passing thru the gastrointestinal tract. In those with full renal function, the uric acid gets filtered by the glomeruli of the kidneys and eventually is excreted in the urine. People with renal problems, tho, often have kidneys that cannot process this uric acid effectively, so hyperuricemia and/or gout can easily develop.

From what I have read, it appears that Allopurinol is often the preferred medication for renal patients because it actually decreases the amount of uric acid that the body produces (which is why it helps prevent acute gout attacks), while the other meds all increase the rate at which uric acid is excreted in the urine. This can make a big difference for renal patients, whose kidneys may not be able to handle the increased excretion rate that other meds like Colchicine or non-steroidal anti-inflammatory drugs are meant to produce.

The side effects of Allopurinol can be many, including:

Most common:
Skin rash or sores, hives, or itching
Not as common – but not life-threatening, either
Diarrhea; drowsiness; headache; indigestion; nausea or vomiting occurring without a skin rash or other side effects; stomach pain occurring without other side effects; unusual hair loss
Rare:
Black, tarry stools; bleeding sores on lips; blood in urine or stools; chills, fever, muscle aches or pains, nausea, or vomiting—especially if occurring with or shortly after a skin rash; difficult or painful urination; pinpoint red spots on skin; redness, tenderness, burning, or peeling of skin; red and/or irritated eyes; red, thickened, or scaly skin; shortness of breath, troubled breathing, tightness in chest, or wheezing; sores, ulcers, or white spots in mouth or on lips; sore throat and fever; sudden decrease in amount of urine; swelling in upper abdominal (stomach) area; swelling of face, fingers, feet, or lower legs ; swollen and/or painful glands; unusual bleeding or bruising; unusual tiredness or weakness; weight gain (rapid); yellow eyes or skin
Very Rare but potentially dangerous:
Loosening of fingernails; numbness, tingling, pain, or weakness in hands or feet; pain in lower back or side; unexplained nosebleeds

If you've been on Allopurinol for a while without incident, chances are that you won’t have side effects down the road. The most common side-effect that CAN crop up, tho, at any time, is a sudden hypersensitivity/allergic reaction that causes a rash. In rare cases, this rash can become severe and widespread enough to be life threatening. It doesn’t happen often, but kidney patients are among those most at risk for developing such a problem. Should a rash of any sort develop at any point, it’s definitely something that needs immediate attention. Sometimes, all that is needed is a change in the dosage of the Allopurinol, but the situation must be addressed early on, as soon as it develops.

In addition, some recent studies into long term use have shown that in some cases, this med can increase the risk for cataracts, but there doesn’t seem to be conclusive evidence as yet.

Last but not least, Allopurinol can react badly with many other meds, so it is essential that the prescribing doctor (and the pharmacist) know exactly what other meds you’re taking, including any non-prescription drugs. Antacids and non-steroidal anti-inflammatory drugs (such as any derived from aspirin or paracetamol) can reduce Allopurinol’s positive effects on gout because they can cause fluctuations in the uric acid level.

Some of the other possible drug interactions can include:
1. Increased action of oral anticoagulants, including: chlorpropamide, cyclophosphamide, hydantoin, theophylline, vidarabine, ACE inhibitors, mercaptopurine, azathioprine;
2. Possible kidney stone formation when taken with: ammonium chloride, vitamin C, potassium/sodium phosphate;
3. Decreased effects of the drug probenecid;
4. Rash, when taken with Ampicillin, amoxicillin, bacampicillin;
5. Decreased effects of Allopurinol when taken with aluminium salts.
6. Increased risk of severe gout attacks when taken with diuretics

Research thus far seems to indicate that if you are able to tolerate Allopurinol when you start taking it and can avoid those meds that tend to interact badly with it, long term use does not seem to have any major consequences other than the possibility of developing a hypersensitivity/sudden allergic reaction, as mentioned earlier. Since this particular reaction does not usually occur on the initial taking of the drug, it is probably the most important thing to watch for while taking Allopurinol long-term.

I do hope this has been of some help. It is all from research I have done, and not from any experience of my own. I remember reading when I was a kid about some of the mighty old kings & their gout attacks, their special velvet-covered footstools and all, and I wondered what “the goutâ€
Cheryl in CT
 
Posts: 412
Joined: Wed Apr 21, 2004 10:17 pm
Location: Connecticut, USA

Gout

Postby Steve Emery » Tue May 25, 2004 12:57 pm

Thanks for your reply it was helpfull

Steve
Steve Emery
 
Posts: 2
Joined: Tue May 18, 2004 11:09 am
Location: Australia

Postby Kiwi Andy » Tue May 25, 2004 8:43 pm

Hi Steve
Welcome to the board. It's good to have someone else from this side of the world where we speak "real" english posting on the board. Since you're from Aussie, I'll type real slow for you so you can understand. I'll get back to you on my (painfull) experience on gout later. I'm at work and just logged in to see who's doin what. Surfin the net at work is frowned upon but because I'm the boss, I guess it's ok for research purposes. Wasting work time is a bad habit I picked up while (supposedly) working in Brisbane a few years back and it's been hard to shake. I'm looking foward to some Aussie / Kiwi bashing and not to worry, I'm really hard to offend!!
Get back to you later.
Andy
p.s Can you find out what the Brumbies had for brekky last Saturday ??
Whatever it was, I'll have a bale of it.
Kiwi Andy
 
Posts: 17
Joined: Mon Apr 26, 2004 1:14 am
Location: New Zealand

'real' English

Postby oldborris » Wed May 26, 2004 10:37 am

Aussies speak 'real' English????? Don't come the old uncooked crustacean with me. Haven't you met Bazza McKenzie, aka Barry Humphries. Now there's a real live fair dinkum bonzer Aussie who eats in restaurants where waiters point the Percy at the patisserie and make Ned Kelly produce liquid laughs and chunder technicolour yawns over the populace. That's real English is it? I still don't understand why Aussies nip into the dunnee to syphon the python. Andy, you must be having a laff.

Incidentally, I was diagnosed with gout some 15 years ago, reporting to the doc with a painful big toe which interupted a hitch-hiking holiday in Spain. It erupted only occassionally and I used Fromax successfully to deal with the pain. Only last year did I learn that it wasn't gout at all but some sort of arthritic problem.
oldborris
 
Posts: 266
Joined: Fri Apr 23, 2004 1:01 pm
Location: Fulham, London, U.K.


Return to The KPG Forum

Who is online

Users browsing this forum: Google [Bot] and 20 guests