Among the many patients with hyperuricemia and gout, there is a common misunderstanding or hidden uneasiness when they take medication, and when they visit the doctor, they often ask the question: “Will taking uric acid-lowering drugs hurt the kidneys?” This deep-rooted traditional awareness of “taking uric acid-lowering drugs will hurt the kidneys” makes many gout patients so afraid that they disregard the advice of doctors and give up the standard treatment of gout. In fact, the kidney damage of hyperuricemia and gout patients is not due to the effect of drugs, but due to the disease itself. They have not taken any uric acid-lowering drugs, but their kidneys have been irreversibly damaged by years of high uric acid. In recent years, the relationship between hyperuricemia and chronic kidney disease has become a research hotspot at home and abroad. Foreign studies have found that the prevalence of chronic kidney disease among patients with hyperuricemia is 15.1%, while among people with normal blood uric acid levels, the prevalence of chronic kidney disease is only 2.9%. The prevalence of kidney damage in patients with chronic gout was high, 86.3%, which was significantly higher than that in the normal population (7.4% ). All of the above studies suggest that hyperuricemia is closely related to the prevalence of chronic kidney disease, and that men are more susceptible to kidney damage from hyperuric acid than women. The reason why hyperuric acid causes serious damage to the kidney is because of the damaging effect of uric acid crystals on the tubular interstitium of the kidney on the one hand, and on the other hand, persistent elevated uric acid can lead to vascular endothelial dysfunction through inflammatory effects, resulting in hypertension, cardiovascular disease and kidney disease, which may eventually develop into end-stage renal failure if left untreated. In addition, renal damage caused by hyperuric acid is often complicated by cardiovascular disease, obesity, hypertension, hyperlipidemia and diabetes, which is a clinical manifestation of metabolic syndrome and is mutually causal. The manifestations of gouty nephropathy include intermittent or persistent proteinuria, usually no more than ++, or trace amounts of hematuria; occasional back pain, which should be alerted to the presence of kidney stones; increased nocturia and decreased urine specific gravity following a decrease in renal tubular concentrating function, etc. So, how can patients with hyperuricemia and gout prevent kidney damage caused by high uric acid? 1, treat this common disease to have a scientific point of view, understand the nature of the disease, not hearsay, listen to the prescription. 2, improve lifestyle, abandon bad habits, such as drinking alcohol, no meat, etc. 3, need to control the diet, drink more water. It is especially important to check uric acid level regularly, to control uric acid, also protect our kidneys. The main purpose of reasonable treatment of hyperuricemia is to protect the kidneys. The “Guidelines for the diagnosis and treatment of primary gout” formulated by the Rheumatology Society of China recommends that dietary control is the mainstay for asymptomatic hyperuricemia, but uric acid-lowering medication is needed if blood uric acid is still higher than 535 umol/L after dietary control; in addition, uric acid-lowering treatment should also be given to patients with family history or associated diseases such as hypertension when blood uric acid is higher than 476 umol/L. Specific measures: 1. Lifestyle treatment: consume low purine, low calorie and alkaline food; strictly abstain from drinking all kinds of alcohol, forbid beer and liquor, and drink red wine in moderation; drink more than 2000m1 of water daily; adhere to exercise and control body weight. Patients do not need to overly strictly control the low purine diet, because exogenous purine only accounts for 20% of the total purine in the body, and, long-term excessive low purine diet will lead to nutritional deficiency. 2. During the acute gout attack period, patients should visit the doctor every 1-2 weeks to control the gouty arthritis attack as early as possible and prevent another attack. Check weight and blood pressure regularly during the interval; report diet, exercise, medication and symptoms to the doctor; have blood uric acid, urine routine (protein, PH value, sediment), blood lipid, kidney function, liver function, blood routine, blood sugar, etc., once every 1-3 months, and have urinary ultrasound and other examinations 2-3 times a year. 3.Uric acid lowering treatment: common drugs to promote uric acid excretion include benzbromarone; drugs to inhibit uric acid synthesis include allopurinol and febuxostat. Uric acid excretory drugs can increase the uric acid content in the urine, for the presence of urinary stones or chronic uric acid nephropathy patients should be used with caution, acute uric acid nephropathy is prohibited. During the medication period, especially within a few weeks of starting the medication, drink plenty of water (more than 2L), alkalize the urine and maintain the urine volume. And be aware of the hypersensitivity syndrome when taking allopurinol. In conclusion, although the same gout patient, uric acid treatment is very delicate, not the same, individualized treatment is needed, patients should not buy uric acid drugs and take them at will (uric acid drugs are prescribed abroad and should not be purchased at will), but should regularly visit the doctor to adjust the type and dosage of drugs. After treatment, if blood uric acid <360μmol/L can be maintained, it can effectively prevent the attack and recurrence of gout; blood uric acid <300μmol/L or lower can reduce and eliminate gout stones, and can prevent joint destruction and kidney damage. Paying attention to hyperuricemia and preventing gouty arthritis attacks, knowing how to scientifically treat and manage personal diet and medication to keep uric acid up to the standard, also takes good care of the kidneys, one of the most important organs in the body. Chronic gout patients especially should always remind themselves that every gout attack is a distress signal from the kidneys to you, to protect it, please pay attention to the standard treatment of uric acid reduction.