88-yr old grandma has first-time gout attack and creatinine is 1.8. now showing signs of slight mental confusion. something else going on? thank you!

Check urea: Urea derived from catabolic liver pathways which in failure can cause hepatic encephalopathy which at first manifest in euphoric confusion mental status changes. She must see a doctor to analyze blood chemistries.

Confusion: Confusion can be caused by many things in the elderly, including infection. She should be re-evaluated if the confusion is a new finding.