Gout As Kidney Disease

Gout is not only an intermittent disease that affects peripheral joints, it’s a disease that's systemic in nature and progressive, says Dr. Bradley Marder, medical director of nephrology with Horizon Therapeutics. As a nephrologist, he sees gout as a kidney disease. In this interview, he explains why.

PARTIAL TRANSCRIPT

“Gout really is not just a disease of the joints like most people assume. It’s actually a disease that has a lot to do with the kidneys. My personal journey considering gout in my patient population with kidney transplants and patients with chronic kidney disease, is kind of interesting in the fact that I really had a frustrating time dealing with gout at the beginning of my career.

“It’s a disease that has a lot of patient complaints, pain, dietary issues. And, the tools, especially when I was beginning my practice were really not that great to take care of patients with gout and chronic kidney disease.

“Over the years, I found that by not dealing with the disease independently, that is, by referring my patients gout issues back to their primary care doctors, or to rheumatologists, I was just simply frustrating patients who had to wait longer to get appropriate treatment and also many health care providers who are not familiar with chronic kidney disease will end up starting these patients on in appropriate medications, like NSAIDs, or incorrect doses of medications that need to be strictly regulated for patients with chronic kidney disease.

“And, so it was through trying to help my patients get better treatments more efficiently, that I really found a better way to think about gout and a better way to treat these patients. In fact, that became one of the most rewarding parts of my practice. Because so much of what a nephrologist does is just making improvements of numbers on pieces of paper and very little do we actually have the opportunity to take care of such a significant disease that patients are suffering form.

“So I found by alleviating the suffering of my patients with gout, I was able to have a rewarding practice that, at the end of the day, I was able to say to myself and even my teenage daughters how much benefit I was giving to patients who were suffering. That was something that I felt I could benefit patients one at a time. But if there’s something that I could do to help educate other nephrologists on how to manage gout in these patients and that they could then pay that forward to help patients in the same way, then I could make a more substantial impact. That’s really the motivation between moving from clinical practice to my role at Horizon in this last year.”