The following is a summary of “Hyperechoic spots in the renal medulla as a potential indicator of early gouty nephropathy,” published in the August 2024 issue of Nephrology by Zhang et al.
Hyperechoic renal medulla could be linked to renal function damage in patients suffering from primary gout, but further understanding is needed.
Researchers conducted a retrospective study investigating the presence of hyperechoic renal medulla in patients with gout, which is associated with specific clinical and biochemical factors, particularly renal function impairment.
They reviewed data from 2,107 patients with gout treated between 2016 and 2022. Clinical and biochemical data were gathered. Patients were grouped based on renal ultrasound findings into hyperechoic medulla (HM) or normal medulla (NM), with HM further divided into partial HM (P-HM) and fulfilled HM (F-HM).
The results showed that out of 2,107 patients with gout, 380 had hyperechoic renal medulla (106 with F-HM, 274 with P-HM). Significant differences in gout duration, number of urate arthropathies, serum urate (SU) levels, tophi, blood urea nitrogen (BUN), serum creatinine (sCr), and estimated glomerular filtration rate (eGFR) were found between HM and NM groups, as well as between F-HM and P-HM (P<0.05). Hyperechoic medulla was linked to longer gout duration, more frequent attacks, higher SU and sCr levels, and more urate arthropathies. Tophi and sCr were primarily linked to F-HM.
Investigators concluded that detecting a high medulla echo in patients suffering from gout via ultrasound often signals kidney damage. They also suggested that P-HM could be a transitional stage between normal medulla and more severe F-HM in patients with gout.
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