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Safety of Colchicine in End Stage Renal Disease

Colchicine toxicity has been linked to renal function and it has generally been advised to adjust colchicine dosing in patients with renal insufficiency.

Two studies have examined the effect of colchicine use in patients with end stage renal disease (ESRD) on hemodialysis.  22 maintenance hemodialysis patients receiving chronic colchicine were compared to 20 not exposed to colchicine. Four of 22 patients were using 0.5 mg/day, 4 patients were using 1.5 mg/day, and 14 patients were using 1 mg/day colchicine. No evidence of overt or subclinical colchicine toxicity was detected based on cell counts, CK or myoglobin levels and myoneuropathic symptoms (Citation source 

Another study examined the effects of single dose 0.6 mg colchicine in cohorts of patients with normal renal function, mild, moderate or severe renal impairment and a cohort of ESRD patients on hemodialysis. Those with mild or moderate renal impairment or those actively receiving hemodialysis do not show accumulation of colchicine, whereas those with severe renal impairment show a doubling of exposure. All patients with renal impairment taking colchicine should be closely monitored, especially as many patients taking colchicine often have other comorbidities and may be taking other medications.

The author has no conflicts of interest to disclose related to this subject

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