Gout Pal Interactive

I don't understand that reference, David, in the context of kidney disease. All it says about kidneys is that if they are already impaired then allopurinol dose may be lower.

As Terkeltaub said last year, when talking about allopurinol failing to reach low enough uric acid in many cases (my bold):

“This situation has been promoted by longstanding, non-evidence-based guidelines for allopurinol use calibrated to renal function (and oxypurinol levels) and designed, without proof of efficacy, to avoid allopurinol hypersensitivity syndrome”

He clearly hadn't read my earlier discussion of New Zealand study on allopurinol dosing in renal impairment. Very clever, these Southern Hemisphere Johnnies. They reckon that dosing above the recommended guidelines be considered, though they do call for additional research.

Once again, your trip out of the cave prompts me to look at more recent research for any additional advice. I had to move north of the equator for this, but maintaining the Eastern influence, we journey to Korea.

A very recent study has suggested better ways to assess kidney impairment. These clever Eastern Hemisphere Johnnies include some interesting points about allopurinol and kidney disease. First, they remind us of the dangers to kidneys from high uric acid:

Murray and Goldberg showed that hyperuricemia was a primary cause of chronic interstitial nephritis in a retrospective study of 101 patients. Recent study determined that hyperuricemia may contribute to the development of chronic gouty nephropathy as well as play a crucial role in the progression of renal pathology.

Then they suggest:

It may be considered that gout patients with renal impairment have allopurinol rather than benzbromarone as a uric acid lowering agent.

But I'm no nearer finding anything showing a bad side of alllopurinol for kidney patients.

Actually in the 1970's the general feeling was that Zyloprim was completely without side effects…remarkable for ANY drug.

It is only lately that quibbles are being made about allopurinol, and I suspect a lot of that stems from it's loss of patent protection (and it's old high price) and the emergence of an expensive new kid on the block…patent protected Uloric.

Allopurinol remains in a rarefied atmosphere of drugs that cause almost NO untoward side effects.

(I've run through the almost entire gamut of anti-hypertensives…dozens of them. If a single one of them was as free of side effects as allopurinol, its maker would get the Nobel Prize and deserve it.)

Interesting resume on Colchicine

http://www.questia.com/library…..hicine.jsp

I found it looking at links over recent reports that macular degeneration is being reversed by Italian researchers using  – Yep!    - Meadow Crocus.

I assume that is not quite the same bits as used for Colchicine  production- or they would surely have called it that.

My herbalist friend linked this report

http://insciences.org/article……le_id=5059

with the comment that Bilberries [or the now popular Blueberries equivalent in UK] are good for AMD. I use them- but not keen, better in a smoothie , I hear.

Maybe useful for gout, too, a la BBB ?