Gouty nephropathy is a renal lesion caused by chronic interstitial tubulopathy due to long-term hyperuricemia and deposition of urate in the kidney. Gouty nephropathy is widespread in patients with gout, with 41% of long-term gout patients reported to have significant kidney damage and 25% to die of renal failure. Patients are mostly middle-aged and elderly, with 80% of them developing after the age of 30 years, and some reported as early as 10 years old. Gout nephropathy is more common in males than females, and in females it occurs more often after menopause. The onset of gouty nephropathy is insidious, often with mild back pain, 40% with mild edema, and 60% with moderate blood pressure elevation. In advanced stages, the lesions involve the glomerulus, and the clinical manifestations of uremia may appear at the end stage, and 17-21% die from uremia or uremic complications. Some studies have reported that 41% of patients with hyperuricemia have clinical symptoms of renal damage, and mild hyperuricemia can worsen renal function and renal dysfunction. About 85% of patients with gout often have supervised or persistent mild proteinuria for several years before significant renal impairment occurs. As the disease progresses and renal impairment worsens, about 10% of patients die from uremia. Most patients with gout have a similar experience at the time of attack, with a history of exertion, cold, alcohol consumption, excessive consumption of animal offal or high purine foods, hunger, infection, trauma, and surgery. The onset of the disease is rapid, often waking up at night because of foot pain, and the symptoms develop to a peak within a few hours, with marked redness, swelling and heat in the joints and surrounding soft tissues, pain so intense that they cannot even tolerate bedding coverage and cannot walk, and may be accompanied by systemic symptoms. Most patients have a tendency to have more and more frequent attacks, and more and more joints are involved, causing chronic arthritis and joint deformity and seriously affecting joint function. Some patients may develop gout stones, which are difficult to heal once the wound breaks down. In addition, many patients can develop renal colic, hematuria, and even renal failure in the late stage. Increased blood uric acid is an important indicator, and patients with recurrent attacks may even have bone rupture. Patients with gout attacks should first be treated for acute gouty arthritis, with bed rest, elevation of the affected limbs, and the use of antipyretic and anti-inflammatory drugs under medical supervision. In the intermittent, chronic and asymptomatic periods, to prevent acute attacks of arthritis and various complications, some uric acid-lowering drugs should be taken for a long time if necessary. It is most important to correct bad habits, quit smoking, drink more water, lose weight, and keep the daily urine volume above 2000 ml to promote uric acid excretion. Avoid eating foods with high purine content, such as seafood (except seaweed and nori), animal heart, liver, kidney, brain and sardines, etc. Spinach, leek, green pepper and soy products also have high purine content and should be avoided. You should also avoid cold, injury and strain, and avoid the use of diuretics and other drugs that affect the excretion of uric acid by the kidneys. Eggs and milk are rich in protein but low in purines. Most vegetables and fruits are not high in purines either. Traditional Chinese medicine has a systematic dialectical theory in the treatment of gouty kidney disease, and the comprehensive treatment of Chinese medicine has more obvious advantages. Modern pharmacological studies have confirmed that Job’s tear, Tu Fu Ling, Poria, Plantago, Phellodendron, Atractylodes. A variety of Chinese herbal medicines, such as Silkworm, Zeilan, etc., have obvious effects of promoting uric acid excretion and reducing uric acid, while Wei Ling Xian and Gentiana Macrophylla not only have the effect of increasing uric acid excretion and anti-gout, but also can promote uric acid dissolution, while Rhubarb, Angelica, Zeilan can even inhibit uric acid synthesis, improve renal blood flow, reduce inflammation exudation and local joint swelling and pain. Chinese medicine treatment can avoid the side effects of some western drugs and, with long-term use, can improve complications and protect kidney function. Gout has a long course and most of it cannot be cured, but it is a manageable disease, especially in terms of protecting the kidneys, which requires timely and effective intervention. The treatment process requires mutual cooperation between patients and doctors and increased knowledge of gout. For patients with gouty nephropathy, the advice given by doctors is: reasonable water control; adequate water intake; regular lifestyle regime; appropriate physical activity; effective medication; and regular health check-ups.