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Kidneys
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I've had my creatinine levels and GFR rate flagged a few times previously, it dropped a little then went back up a bit but in it's been flagged again as it had gone down to the low 60s, they retested and I got called in (about a week later) as it has dropped again to 55 and have been referred to the hospital to see a specialist.
Is a drop like that likely to be worrying, also given the swelling I've had in my feet and ankles and recent pitting edema in my legs?
Thanks for any help.
Is a drop like that likely to be worrying, also given the swelling I've had in my feet and ankles and recent pitting edema in my legs?
Thanks for any help.
Answers
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Well.....it does indicate an degree of chronic kidney disease (CKD) of which there are 5 stages and you seem to be slipping out of one stage which is within normal limits (Stage 2) to one which may, or may not be more significant (Stage 3).
That "drop" would not worry me, but one would need to keep an eye on it,say retested every 4 months and i doubt very much that your CKD would cause your swollen ankles.....it might.......but i doubt it.
That "drop" would not worry me, but one would need to keep an eye on it,say retested every 4 months and i doubt very much that your CKD would cause your swollen ankles.....it might.......but i doubt it.
Hi Eve - the reason for referral ( to a renal physician I presume) even though the fall in GFR is modest is because you are on drugs which are potentially toxic to the kidneys, so it is important to find out exactly how good your renal function is.
Are you back on methotrexate now?
As regards the swelling of the legs it depends whether you are losing protein or not. Do you happen to know whether you have protein in the urine, or what a recent serum albumin level is?
Are you back on methotrexate now?
As regards the swelling of the legs it depends whether you are losing protein or not. Do you happen to know whether you have protein in the urine, or what a recent serum albumin level is?
Thanks both. I'm not on methotrexate at the moment, was off it for ages due to raised ALT levels. They went back down and I was on it again, only 15mg, for two injections, I queried whether it could be causing hairloss and if I could do anything to prevent that and they took me off it - must have been about November though I don't now how long these kinds of drugs lurk in your system.
Serum albumin was fine I think (from the time before), not sure if they retested that too or just did the usual kidney stuff, it was the creatinine level they flagged at over 100. She did a dip test when I went in with the edema and said there was a trace of protein, didn't sound like much. I've got to hand a "first catch of the day" one in later.
Maybe it will have a bearing on what I can take though (or monitoring), bit up in the air at the moment anyway, was given lefludomine but after my googling I raised it would work much given I'm taking Cholastagel for malabsorption, and other issues, so they are looking into things. I am rather fed up!
Serum albumin was fine I think (from the time before), not sure if they retested that too or just did the usual kidney stuff, it was the creatinine level they flagged at over 100. She did a dip test when I went in with the edema and said there was a trace of protein, didn't sound like much. I've got to hand a "first catch of the day" one in later.
Maybe it will have a bearing on what I can take though (or monitoring), bit up in the air at the moment anyway, was given lefludomine but after my googling I raised it would work much given I'm taking Cholastagel for malabsorption, and other issues, so they are looking into things. I am rather fed up!
Have been having a think, do either of you know how toxic methotrexate is to kidneys, in my case, whether it would be a possible reason for it to be avoided? Something I could think about while waiting to be contacted as they have been talking about getting me back on it. I've lost a bit of faith after my last appointmenr (for a number of reasons) so want to try and get myself as informed as possible before I speak to them again.
Difficult EVE.
In my opinion in low doses methotrexate is NOT nephrotoxic (damages the kidney) but if higher doses are needed and your renal function tests are normal, then the chances of nephrotoxicity is very small....probably 1%.
However if you have impaired renal function to begin with then the chances of high dosage methotrexate damaging the kidneys may become a significant factor and needs to be judged against the danger of the clinical condition for which their have been suggested.
You seem to have Stage 2 to stage 3 CKD and this must be taken into consideration.
Slaney and /or a Nephrologist would give a better opinion.
In my opinion in low doses methotrexate is NOT nephrotoxic (damages the kidney) but if higher doses are needed and your renal function tests are normal, then the chances of nephrotoxicity is very small....probably 1%.
However if you have impaired renal function to begin with then the chances of high dosage methotrexate damaging the kidneys may become a significant factor and needs to be judged against the danger of the clinical condition for which their have been suggested.
You seem to have Stage 2 to stage 3 CKD and this must be taken into consideration.
Slaney and /or a Nephrologist would give a better opinion.
Thanks for that Sqad. I think they are thinking a low dose though I don't think that will help much (unless with something else) I'm nervy after it also sending my ALT up too, although that is now back down now I'm off it, and, with only being 35, worried about the damage to organs and extra time I have to need them and possible consequences if damage happens which can't be undone.
I understand that things are getting more complicated decision wise and something(s) will have to give, I just want to try and be informed and try to make the best decision what and so I can try and ask the right questions at appointments.
My GP is looking into the hairloss issue too to see if there is some other cause and checking my thyroid again (last done July) to see if the methotrexate can be ruled out as causing that.
I understand that things are getting more complicated decision wise and something(s) will have to give, I just want to try and be informed and try to make the best decision what and so I can try and ask the right questions at appointments.
My GP is looking into the hairloss issue too to see if there is some other cause and checking my thyroid again (last done July) to see if the methotrexate can be ruled out as causing that.
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