Which medication is contraindicated in patients with kidney disease who have acute gout?

In patients with kidney disease who have acute gout, nonsteroidal anti-inflammatory drugs (NSAIDs) can indeed pose a significant risk due to their potential impact on kidney function and ability to cause fluid retention. Structural changes in the kidneys can limit the excretion of NSAIDs, leading to elevated blood levels and an increased risk of adverse effects such as worsening kidney function or acute kidney injury.

While colchicine, indomethacin, and intraarticular steroid injections have variable degrees of safety and effectiveness in treating acute gout, NSAIDs should generally be avoided in patients with compromised renal function. This is particularly pertinent for individuals with severe kidney disease where NSAIDs can exacerbate existing conditions.

Therefore, when managing acute gout in patients with kidney disease, it is crucial to select alternative treatments and avoid NSAIDs to ensure patient safety and prevent further renal complications.