Currently, glucocorticoids are the only treatment option for acute gout attacks in patients with chronic kidney disease (CKD) and progressive renal dysfunction. Management becomes particularly challenging when steroid therapy is contraindicated, poorly tolerated, or ineffective. IL-1β monoclonal antibodies offer potent, targeted anti-inflammatory effects and have been approved for the treatment of gout, providing new therapeutic hope for this population. Here, we report a case of a patient with CKD and progressively worsening renal function who experienced an acute gout attack requiring dialysis. Treatment with the IL-1β monoclonal antibody Firsekibart produced rapid and remarkable anti-inflammatory and analgesic effects, effectively controlling the gout attack, improving renal function, and allowing discontinuation of dialysis.