Middle-aged and older male patients with nephropathy, Performance with gout (joint disease and tophi), serum uric acid> 357 micro-molar / liter, urinary uric acid excretion increased (> 1 g / day), urine analysis and renal interstitial nephritis was performance, uric acid can be diagnosed with nephrotic syndrome. Judgment is the main differential diagnosis is primary or secondary to other kidney disease.
(1) The former serum uric acid / blood from a muscle> 2.5, uric acid increased more prominent, the latter ratio was increased. (2) the former accompanied gouty arthritis or acute gouty joint disease, multiple joints involved Heading toe first, the latter rare.
(3) The former urinary uric acid hyperlipidemia before seen in the azotemia, the latter is not.
(4) the latter many other kidney history.
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