Artritis Gout dengan Nefropati Urat: Suatu Studi Kasus  

Oleh:

Kertia, Nyoman ; Widodo, Sri

Jenis: Article from Journal - ilmiah nasional
Dalam koleksi: Berkala Kesehatan Klinik vol. 15 no. 01 (Jun. 2009), page 56-67 .
Topik: artritis gout-uric nephropathy

Ketersediaan

Perpustakaan FK Nomor Panggil: B25.K.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background: It is not easy to treat properly when the patient has the combine of gout arthritis and nephropathy. Some drugs for relieving the symptom of acute gout and some uric lowering agents are able to reduce the kidney function. In the other hand some drugs which believed to increase the kidney function can increase the uric acid level. Objective: To discuss the best way in treating the patient suffering of gout arthritis with uric nephropathy Case: A 54 years men with chronic tophaceus gout come with acute artritis on right knee and elbow. The ureum and creatinin level is increased, hyperpotasemia. hypoglycemia, hypoalbuminemia. The X ray reveal an osteoartritis apearence of the right knee. There are some tophyon his metatarsophalangeal joints. The treatment given are colchicine (is stopped after the laboratory result show there is a renal insufficiency) , oral and intra-articular corticosteroid. The hyperpotasemia, hypoglycemia and hypoalbuminemia are corrected. The appearance of abdominal USG and BNO are normal. Allopurinol is given in oder to decrease the uric acid level. Meloxicam is added for releaving the inflammation and pain. Cyprofloxacine is given for his uroseptic condition. Discusion and Conclusion: Some time there is a concomitant of gout arthritis and osteoartritis as we find in this patient. The renal failure in this patient is more likely caused by the uric nephropaty, because the chronic gout arthritis is underwent by patient for a long time while the kidney failure is not so severe. It is hard to say that the renal failure of this patient result in the hyperuricemia. In some patients the development of uric stone cause the renal failure but in this patient is not likely. The joint inflammation in gout arthritis is commonly severe. Colchicine, corticosteroid and non steroidal anti-inflammatory drugs (NSAIDs) are some important drugs for releaving the acute gout symptom. The use of colchicine and NSAIDs is insufficient in this condition due to side effect of these drugs. Corticosteroid treatment given oralyand intra-articular is drugs of choice for this condition. The antibiotic become important for this case because patient suffers from uroseptic as well. Allopurinol is able to suppress the kidney function while probenecid and sulphinpyrazon is contraindicated. Therefore, it could be concluded that the use of anti-inflammatory and allopurinol should be given carefuly those patients suffer from acute gout arhtritis and renal failure.

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