Table 4.

Treatment of crystal arthropathies in chronic kidney disease and dialysis patients

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

CKD, chronic kidney disease; GFR, glomerular filtration rate; NSAID, nonsteroidal anti-inflammatory drug.