Complications Of Colchicine Initiation in a Patient with Chronic Kidney Disease

We report a case of a 76-year-old female with stage 4 chronic kidney disease (CKD) who experienced multiple adverse events following the initiation of colchicine for a gout flare. Diarrhea led to further complications, including acute renal failure, hypercalcemia, and bradycardia. The patient additionally developed the less common toxicities of myelosuppression and presumed myopathy, resulting in prolonged hospitalization with persistent functional impairment at the time of discharge. This report highlights the importance of exercising caution when prescribing colchicine to patients with severe CKD. It discusses alternate ways to manage acute gout as well as strategies to minimize the risk of adverse events when using colchicine in this population.