Gout as an indication of kidney function?

[Matt Lewis]

Dr. Goldfarb,
Kathy has been having increasing problems with her knees. Recently, she has trouble even going up and down a single flight of stairs. Although there are some other things that may be making this condition worse (she is on her feet for the entire working day), i wonder if perhaps she is experiencing gout. If this is the case, i also wonder if the buildup of uric acid could be caused by/an indicator of poor kidney function. We're getting her into the doctor to have it checked out and i assume that bloodwork will be done to verify or discard high blood [uric acid].
Is this something that cystinurics commonly face, and if by chance she is faced with gout, should we suspect a kidney problem due to cystinuria?
Thank you in advance for any and all info.
Kind Regards,
matt

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[DAVIDGOLDFARB]

Matt, Kathy, hard to relate this to kidney disease, either decreased kidney function as the result of nephrectomy, procedures, multiple stones, or just to cystinuria (I don't know what Kathy's creatinine is, so when you get lab results you can send them to me). She's too young to have gout: not impossible but it would be SO unusual; and she's not the (statistically) correct gender. And most gout is not this sort of chronic thing: it's VERY acute: red, hot, swollen joints. There's a chronic form but it's almost always after YEARS of acute episodes. So seeing an orthopedist is a good idea if possible. I realize that many people taking thiol drugs (Thiola, penicillamine) complain of various musculoskeletal pains and most of that I tend to think is simply our age-related changes that we are never prepared for. I don't think that people keep in mind the right control group, and believe me the 40-50 year olds ALL have these complaints as well without the thiol drugs. That of course is not to say that the drugs don't have side effects, but that it is hard to be sure, and I'm sympathetic. Over all the way this sounds now it is not likely to be related to cystinuria.
Keep in touch.