Question

A 52-year-old with recurrent gout flares (5/year), tophi, and serum urate 9.2 mg/dL has CKD stage 3a. Best long-term management?

Accepted Answer

Begin allopurinol 100 mg daily with titration to urate <6 mg/dL and flare prophylaxis

Answer

Start febuxostat 80 mg daily without prophylaxis

Answer

Avoid urate-lowering therapy; treat flares only

Answer

Start probenecid 1,000 mg daily as first-line

Answer

Start pegloticase immediately

Practice question

A 52-year-old with recurrent gout flares (5/year), tophi, and serum urate 9.2 mg/dL has CKD stage 3a. Best long-term management?