رجل عمره ٥٨ سنة عنده مرض كلى مزمن في المرحلة الثالثة، جاءته نوبة نقرس في إصبع القدم، فاشترى ديكلوفيناك وأخذه ٥ أيام. الآن بوله قل، والكرياتينين ارتفع من ١٫٦ إلى ٢٫٥، والبوتاسيوم ٥٫٨. الضغط ١٥٠/٩٠. ما التعليم الأهم بعد علاجه؟

A 58-year-old man with stage 3 CKD had a gout attack in his toe and took over-the-counter diclofenac for 5 days. Now his urine output is lower, creatinine rose from 1.6 to 2.5 and potassium is 5.8. BP 150/90. What is the most important teaching after treatment?

1. Double the diclofenac dose with the next attack
2. Drink less water to reduce the load on the weak kidney
3. Avoid NSAID painkillers and see the doctor for gout treatment
4. Eat more red meat to replace lost protein

Answer: C) Avoid NSAID painkillers and see the doctor for gout treatment. NSAIDs reduce renal perfusion and raise potassium and are dangerous in CKD. Gout is treated with alternatives chosen by the doctor, such as dose-adjusted colchicine or steroids.