How do you use colchicine for gout in patients with chronic kidney disease or end-stage renal disease on hemodialysis?

As a last resort agent and with a lot of caution. For prophylaxis, half a 0.6 mg pill two times a week, carefully monitoring CBC and CK levels. If medication interactions are of concern, then do not use.

For flares, a much better alternative would be glucocorticoids or even anakinra. NSAIDs could be...

Agree with the reduction in dose according to GFR levels and a unique steroid shot.