November 25, 2009 at 10:39 pm #3093phofabParticipant
Relates to the long term sufferer with an excessive buildup of UA crystals and tophi.
- Has any research been done into hitting the long term sufferer with large doses of Allopurinol to bring about a quick result?
- Does the impact of rapidly releasing a large build up of UA crystals have a negative effect on the kidneys?
If clearing a river which has been dammed up overlooking a town site.
- Is it better to create a diversion that will allow a controlled flow towards the town?
- Or simply blast the centre obstruction and release massive amounts of water?
I'll go back into my cave now.November 26, 2009 at 5:28 am #6682Keith Taylor (GoutPal Admin)Participant
- Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout. Some of the lower uric acid levels in this study used a combination of allopurinol with benzbromarone, which is not available in USA. The study notes the case of an allopurinol user who acheived uric acid levels less than 4mg/dL who got rid of all urate deposits in 2 years. More importantly, it includes the best final sentence I've read – “There is much more to the therapy of hyperuricemia than simply prescribing 300 mg/day of allopurinol. How much? As much as necessary to obtain low serum urate levels.”
OK, maybe I should expand a little on answer 2.
For kidney disease sufferers, allopurinol is very good for the kidneys. Essentially, the reduction of uric acid helps the kidneys, but that is only really relevant to people who already have kidney problems.
Allopurinol does not cause an overload of uric acid as old crystals dissolve. The amount of uric acid released is much less than was previously hitting the kidneys when no allopurinol was taken. The uric acid from dissolving crystals is small compared to the decrease in uric acid production.
Most risk comes from allopurinol itself, or rather it's metabolite, oxypurinol. This passes through the kidneys, and can result in kidney stones – hence the advice from many authorities to maintain high urine flow, and alkalize the urine.November 27, 2009 at 3:35 am #6684phofabParticipant
Thank's Keith. You must have a photographic memory or a very efficient filing system.
My compliments to you.
DavidNovember 27, 2009 at 11:49 am #6686Keith Taylor (GoutPal Admin)Participant
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