From the FDA Drug Label
Gout is a metabolic disorder which is characterized by hyperuricemia and resultant deposition of monosodium urate in the tissues, particularly the joints and kidneys. The etiology of this hyperuricemia is the overproduction of uric acid in relation to the patient's ability to excrete it If progressive deposition of urates is to be arrested or reversed, it is necessary to reduce the serum uric acid level below the saturation point to suppress urate precipitation.
The complication that would be a result of no treatment for gout is impaired joint mobility and kidney damage. This is because the deposition of monosodium urate in the tissues, particularly the joints and kidneys, can lead to damage and impairment of these organs if left untreated 1.
- Key points:
- Gout is a metabolic disorder characterized by hyperuricemia
- Hyperuricemia leads to deposition of monosodium urate in joints and kidneys
- Untreated gout can lead to impaired joint mobility and kidney damage
- Reducing serum uric acid level can help suppress urate precipitation and prevent further damage 1
From the Research
Untreated gout can lead to several serious complications, including impaired joint mobility and kidney damage, which can significantly impact morbidity, mortality, and quality of life. Chronic gout may cause permanent joint damage and deformity as urate crystals continuously deposit in joints, leading to erosions, bone destruction, and reduced mobility 2. Tophi (hard, painful nodules of urate crystals) can develop under the skin near joints, on the ears, or other locations, potentially causing skin ulcerations and infections. Kidney damage is another significant risk, as uric acid crystals can form kidney stones and lead to chronic kidney disease through urate nephropathy 3. Untreated gout increases the risk of cardiovascular problems, including heart attack and stroke, due to the systemic inflammation it causes. Additionally, gout flares become more frequent and severe when left untreated, significantly impacting quality of life with intense pain and disability. The psychological impact of chronic pain can lead to depression and anxiety.
Some key points to consider:
- Gout is a common form of acute inflammatory arthritis caused by the deposition of monosodium urate crystals within synovium of joints 2.
- Urate-lowering therapies, such as allopurinol and febuxostat, aim to prevent gout flares and reduce the risk of complications 4.
- Early treatment with medications to lower uric acid levels, along with anti-inflammatory medications during acute attacks, can prevent complications by maintaining uric acid at normal levels and reducing crystal formation in joints and tissues 5.
- Long-term persistence of xanthine oxidase inhibitors (XOIs) as first-line urate-lowering therapy among patients with gout was suboptimal, and febuxostat had better persistence rates than allopurinol 6.
Given the potential complications of untreated gout, it is essential to prioritize treatment to prevent impaired joint mobility and kidney damage, and to maintain quality of life. The most appropriate answer is d. Impaired joint mobility and kidney damage.