Chronic Gouty Nephropathy: A Vanishing Syndrome?

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Abstract
One of the earliest descriptions of gouty or hyperuricemic nephropathy was given by Todd in 1849, who found "in the pyramidal portion white streaks of a crystalline character consisting of urate of soda." 1 The deposition of these crystals in the terminal tubular segments, with secondary giant-cell reaction, obstruction, pyelonephritis, and renal failure, offered an apt explanation of chronic hyperuricemic nephropathy. Over the years the concept broadened, and chronic hyperuricemia was blamed for producing other lesions as well, including an inflammatory interstitial reaction secondary to urate deposits or presumed tubular injury, vascular lesions involving small and large vessels, and even glomerular . . .

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