BMJ Case Reports 2012; doi:10.1136/bcr.02.2012.5814
  • Reminder of important clinical lesson

Successful use of allopurinol in a patient on dialysis

  1. Timothy J Furlong4
  1. 1Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia
  2. 2St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
  3. 3Department of Nephrology, St Vincent's Clinic, Sydney, New South Wales, Australia
  4. 4Department of Nephrology, St Vincent's Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Professor Richard Osborne Day,{at}


We report the case of a man with chronic tophaceous gout who had end-stage renal failure secondary to the Alport syndrome. Following a failed kidney transplant, where urate deposition was a suspected contributor, the patient responded positively to consistent allopurinol therapy and regular haemodialysis sessions. Extensive and destructive tophi receded in size remarkably and the almost constant incidence of acute attacks of gout subsided. The patient has recently received a new kidney transplant and his plasma concentrations of urate are controlled well with allopurinol and he no longer experiences acute attacks of gout. While efficacious, adherence is critical for achieving the therapeutic effects of allopurinol even in end-stage renal disease.


  • Competing interests None.

  • Patient consent Obtained.

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