Gout meds to lower uric acid and chronic kidney disease

Better late than never. I was away for quite a while, because I was asked to come out of retirement, which I did. Now I am re-retired, unless I get drafted again. That's why I had scarce time to contact you and the discussion groups.
Your advice about tart cherry juice concentrate was better than the rheumatologist's, whom I no longer treat with. I've been buying it through Amazon, using 3 tablespoons in an extra-large glass of water every morning along with 100 mg allopurinol. My PCP heartily agrees with using it as a permanent supplement to the allopurinol. Uric acid reduced from a high of 10.2 to a recorded low of 6.1. No gout attacks, only 1 major flare, and only minor temporary flares in the 8 months on this regimen.
Thank you.

So glad to hear that the Tart Cherry is working for you. I actually haven't heard of anyone that didn't have improvement. I get it from FruitFast-Brownwood Acres. I get 3 quarts for $17.95 a quart + $53.85. Different companies have different deals so check around but be sure it is Montmorency cherries. If you can get to 6 and below I would ask your MD about getting off the allopurinol as that seems to be the line of issues or not it seems.

There are not a lot of studies involving CKD, but it has been looked at concerning cranberry. Biggest problem is that many sources add large amounts of sugar for taste. I make smothies with fresh frozen cranbery and add low sugar yogurt with other fruit for flavor.
https://pubmed.ncbi.nlm.nih.gov/31140512/
https://onlinelibrary.wiley.com/doi/10.1002/efd2.33
https://pubs.rsc.org/en/content/articlehtml/2019/fo/c9fo00375d
https://www.kidney.org/news/keephealthy/newsletter/FallWinter2013/KH_Cranberry-Kidney-Connection

I was diagnosed with Stage 4 CKD in 2018. Thankfully, due to diet and increased hydration, I’m now at Stage 3B. I’ve had a severe gout attack with a uric acid level of 10.2. I also looked at cherry and cranberry juice but the potassium level is high in both. I’ve been on 100mg Alpurinol once a day for over a year and my uric acid is now less than 6.

I had gout issues starting many years ago. Colchicine was given for acute symptoms and would alleviate pain in a day or so. After several attacks over about 5 years, I was given allopurinal to more effectively reduce uric acid. It prevented gout attacks altogether. I just received a kidney transplant and have no gone off it. Uric acid is normal with the new kidney.

I've been getting mine from Cherry Bay Orchards through Amazon, 2 quarts for $44.99. Yours sounds like a better deal, which I'll check out at reorder time.
What I find really interesting is your suggestion about eliminating allopurinol if I get below 6. All the medical people I've treated with tell me allopurinol is for life. My PCP says he's never seen any side effects. But, like you, I'm not a big fan of taking too many meds. For example, I parted ways with my rheumatologist when she told me to continue with colchicine despite my stage 3 CKD. Her alternative was prednisone, which attacks bones. I thought her estimated initial dosage times of 3 months was enough to create irreversible damages.
I'd like to stop the allopurinol, if possible, and I'm wondering what your thinking is. Hunches and anecdotes are completely acceptable.

I have used Cherry Bay in the past. It seems different companies have the best deal at different times. As long as it is Montmorency cherries from Michigan I buy the cheapest. As far as your meds certainly it is a decision you need to make along with your doctor. I still have old allopurinol, prednisone, and colchicine sitting in my bathroom and I'm sure it is far outdated but remembering the pain I keep it in case. In the research that I did years ago and in talking to my internist MD and Mayo nephrologist they both agreed that gout was rare when uric acid stayed below 6. I was 14-16 when I started tracking it. There is no doubt that the lower protein intake has helped me as well as losing weight. But, touch wood, I haven't had an outbreak in years but my still and always swollen joint of my great toe will never let me forget. I will try to attach a protocol I wrote up to give to patients

GOUT

Supplemental Support:

600mg Celery Seed extract 1x day 3 x times a day during flare up
375mg Bilberry fruit extract
8 oz Montmorency cherry juice 1 x day or 3-4 tablespoons of concentrate 2-3 x day during flare up – can buy concentrate but must be Montmorency Cherry Juice
Cherry Bay Orchards Tart Cherry Concentrate
https://leelanaufruit.com/shop/all-products/leelanau-fruit-co-cherry-concentrate-32oz/
https://www.fruitfast.com/cherryjuice?gad=1&gclid=Cj0KCQjw9deiBhC1ARIsAHLjR2B2V5w7mFZHwSpr3c95qHsKK7nMG1f8xPGDrbI4XERfW7SRJ_AstaQaAoPQEALw_wcB
1000mg Fish oil/Omega 3 1 x day 2-3 x day during flare up
Bromelain 500mg. 1 x day 2-3 x day during flare up
Magnesium complex 400mg 1 x day 2 x day during flare up
Supplements can be bought from Puritan.com for a reasonable price
Avoid the Following:
Eliminate purine’s from diet: No pork, organ meats, beans, peas, lentils or seafood. Go easy on proteins especially during episodes. During a flare up eliminate proteins from animals.
Eliminate: All alcohol, fried foods, processed foods, refined carbohydrates, and caffeine containing foods such as coffee, tea, cola, and chocolate.
Sugar and refined grains: Raise blood sugar and stress the adrenal glands, feed yeast, increases dysbiosis and cause a myriad of serious health problems.
Chemical additives: The average American consumes ten pounds of food additives each year. This stresses the liver and the immune system.
Hydrogenated oils and fried foods: Hydrogenated oils promote inflammation and cardiovascular disease, while decreasing immunity and hormonal health. Nerves and brain function are also affected.
Repetitious eating: The foods that one becomes sensitive to are usually those eaten on a daily basis. A simple rotation diet minimizes stress to the immune system from hidden allergies. Try eliminating common allergens such as wheat and other grains, dairy, corn, soy, citrus fruits, chocolate, coffee, and soda.
Processed and packaged foods: These foods are devoid of real nutrition. Processed and packaged foods create nutritional deficiencies, diminishing one’s health and vitality.

Basic Rules about Eating and Lifestyle:
Drink eight 8‐ounce glasses of pure water every day: You need water to eliminate toxins.
Most of the food you consume (more than 50% by volume) should be vegetables: Vegetables are high in antioxidants, trace minerals, fiber, vitamins, minerals, and other nutrient

Give Blood – It has been found that pre-menopausal women virtually have no cases of gout. It is based on the iron level in the blood. Menstruation causes loss of iron. After menopause iron can accumulate and is found to increase the risk for gout. Give blood as often as possible. This is true for men and women.

Sorry I could not attach the file and pasting it here changed the formatting.

This is very much appreciated, for you going above and beyond the call of duty. I will do my best to process your motherlode of information.
I once asked a doctor if anyone knows what the long-term effects of all the chemicals in our prescribed drugs are. His honest answer was no. So as much as possible I try to rely on natural processes...not always successfully.
With all your knowledge, I don't know how to reciprocate. But feel free to contact me if would ever like to reach out. Private messages can be easier, if you choose to.
Keep up the good work you're doing.

This is cherry season. I try to get to the local farmers market to buy tasty fresh picked cherries. The stores have them too. It's fresh fruit, which dieticians recommend, and the sugar is natural, not processed. It may not be the same as tart cherry concentrate, but you never know, and it tastes good.