{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T18:14:52Z","timestamp":1759342492239,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,1,16]]},"abstract":"<jats:p>A 33-year-old male with poorly controlled chronic tophaceous gout and chronic kidney disease (CKD) with estimated glomerular filtration rate (GFR) of 37 cc\/min. His uric acid was 11\u2009mg\/dL despite maximal dosing of febuxostat. He had previously failed pegloticase infusions as well. This patient had a reduction in his uric acid level to less than 6\u2009mg\/dL following addition of probenecid to his febuxostat regimen. Most guidelines recommend against utilisation of probenecid therapy in patients with GFR &lt;50, but there is no obvious contraindication to its use, provided renal calculi do not develop. Our case illustrates the synergistic effect probenecid can add to maximal xanthine oxidase inhibitor therapy for patients with refractory hyperuricaemia in a patient with CKD stage IIIb. With the approval of a new uricosuric medication, lesinurad, probenecid may remain a suitable alternative for patients with financial limitations to achieve target uric acid levels.<\/jats:p>","DOI":"10.1136\/bcr-2017-222845","type":"journal-article","created":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T08:35:51Z","timestamp":1517387751000},"page":"bcr-2017-222845","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Effective uric acid reduction with probenecid and febuxostat in a patient with chronic kidney disease"],"prefix":"10.1136","volume":"2018","author":[{"given":"Robert","family":"Case","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Wentworth","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant","family":"Jester","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,31]]},"reference":[{"key":"2025082623303028000_2018.jan31_1.bcr-2017-222845.1","unstructured":"Probenecid tablets [prescribing information]. Corona (CA): Watson Laboratories Inc, 2003."},{"key":"2025082623303028000_2018.jan31_1.bcr-2017-222845.2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"2025082623303028000_2018.jan31_1.bcr-2017-222845.3","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.101160"},{"key":"2025082623303028000_2018.jan31_1.bcr-2017-222845.4","doi-asserted-by":"crossref","first-page":"778.1","DOI":"10.1136\/annrheumdis-2015-eular.2182","article-title":"SAT0329\u2005Lesinurad, A Novel Selective Uric Acid Reabsorption Inhibitor, in Combination with Febuxostat, in Patients with Tophaceous Gout: the Crystal Phase III Clinical Trial","volume":"74","author":"Dalbeth","year":"2015","journal-title":"Ann Rheum Dis"},{"key":"2025082623303028000_2018.jan31_1.bcr-2017-222845.5","first-page":"2524","article-title":"Analysis of gout subjects receiving lesinurad and allopurinol combination therapy by baseline renal function","volume":"67","author":"Saag","year":"2015","journal-title":"Arthritis Rheumatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222845","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:30:39Z","timestamp":1756276239000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222845"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,31]]},"references-count":5,"alternative-id":["10.1136\/bcr-2017-222845"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222845","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,1,31]]}}}