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 | Â | |
   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 | Â | |
   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 |