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Table 4 Treatment of crystal arthropathies in chronic kidney disease and dialysis patients

From: Renal co-morbidity in patients with rheumatic diseases

Drug CKD stage 3 and stage 4 patients (GFR 15 to 59 ml/minute/1.73 m2) Dialysis patients (GFR <15 ml/minute/1.73 m2)
Pain control in acute gout attack  
   NSAIDs Avoid when possible or use with great caution May be used with caution
   Colchicine Avoid when possible or use with great caution (for example, 0.5 mg three times per week) Avoid whenever possible
   Glucocorticoids Short-term use possible (for example, 20 mg/day) Short-term use possible (for example, 20 mg/day)
   Anakinra Effective (100 mg/day for 3 days) but yet limited data published Not evaluated
Maintenance therapy  
   Allopurinol Reduce dose to 100 to 150 mg or avoid Avoid
   Colchicine Avoid when possible or use with great caution (for example, 0.5 mg three times per week) Avoid whenever possible
   Anakinra Not evaluated Effective in case reports (100 mg three times per week)
   Febuxostat Safe at GFR >30 ml/minute/1.73 m2 Not evaluated
   Benzbromarone Probably ineffective at GFR <50 ml/minute Ineffective
  1. CKD, chronic kidney disease; GFR, glomerular filtration rate; NSAID, nonsteroidal anti-inflammatory drug.