How do you manage persistent hyperuricemia in a patient with CKD3 and type 2 diabetes who has had severe reactions to both allopurinol (SJS) and febuxostat (drug rash), but only a single prior gout flare?

I would just recommend conservative management in this scenario.

Unclear if there is an overneed to initiate any uricosuric agents in this scenario, given just single gout flare.

If there was a history of uric acid stones, then would consider an alternative but that would be challenging, given canno...