[Course and prognosis of nephropathy in gout]

Proceeding from the results of a study of 139 patients suffering from primary gout with kidney involvement the authors have defined 4 clinicomorphological types of nephropathy which differed both in their course and prognosis. The I proteinuric type was characterized by early signs of stable proteinuria, sometimes with the development of the nephrotic syndrome in which a morphological study revealed mainly glomerular changes. The II urolithic type was characterized by the appearance of renal colics at the onset of nephropathy, frequently with the passage of concrements (a morphological study revealed mainly tubular and stromal lesions). The III hypertensive type was characterized by the appearance of persistent arterial hypertension (a morphological study revealed mainly vascular and interstitial changes). The IV latent type was characterized by the absence of or a transient urinary syndrome (a morphological study showed mainly interstitial changes). The first signs of renal failure in these types of nephropathy developed, on an average, 7, 15, 11 and 12 years later, the 20-year survival was 24, 92, 68 and 100%, respectively.