Gout can be managed with dietary changes, medicine, and management of other conditions that raise uric acid levels.
Sudden gout flares: non-steroidal inflammatory drugs (NSAIDs) like ibuprofen and naproxen are pills usually avoided in CKD. The pill colchicine is often used, but the dose is lowered for people with CKD. Cortisone is sometimes used in CKD, and can be given as a pill or a shot.
Long-term treatment to lower uric acid and prevent gout flares: allopurinol, febuxostat, probenecid, and lesinurad are all pills. Pegloticase is given through a vein for severe gout that doesn’t get better with pills. When you start long-term therapy, you’ll also take one of these medicines for a while to prevent gout flares: colchicine; an NSAID if it’s safe for you; or cortisone.
Avoid or limit high purine foods and drinks like organ meats, shellfish, beer, and products with high-fructose corn syrup. Eating less animal protein like meat keeps the urine less acid, which may lower the risk for gout flares and kidney stones. Eat lots of vegetables and fruits.
Drink plenty of water, unless your healthcare professional says you need to restrict your fluid intake. Drink water at night too, when crystals tend to form more often.
Treat kidney disease, obesity, high blood pressure, high blood sugar, and heart disease, because they may increase uric acid and the risk for gout. Review all medicines and supplements with your healthcare professional, as some can increase uric acid.