Low GFR

[KimO]

My daughter has a kidney panel done every two weeks along with her CBCs. This week came back with a 1.22 on Creatinine, which is higher but still within the normal range. The worrisome thing is a GFR of 55, which the lab report says indicates stage 3 kidney disease. Her hemotologist office has instructed her to drink more water (which I had already done) and will retest this along with cyclosporine trough this week. Does this indicate permanent damage or just something to monitor?

[Hopeful]

I remember having this happen to me, and I also panicked! At the time, I was taking more than 5 mg/kg/day of cyclosporine, which is not recommended. Is your daughters dosage less than 5 mg/kg/day?

I lowered my cyclosporine to 5 mg/kg/day and increased my water intake, and the GFR was back in the normal range by the next week.

With creatinine, you really want to pay attention to the "percentage over baseline". The drug manufacture warns that you should not let your creatinine exceed 30% of your baseline for an extended period of time without risking permanent kidney damage. The baseline is your pre-treatment creatinine level. So even if her creatinine is in the normal range now, it may not be normal for her if it is >30% of her baseline! A nephrologist that I consulted with also recommended checking for protein in your urine every 6 months, as an indicator of struggling kidneys.

Hopefully, it is nothing but a blip and something that can easily be corrected by increasing her water intake or lowering her dosage.

[KimO]

Thank you, Hopeful, for your encouraging reply. Numbers today look better. Creatinine is still > 30% of baseline but down 17% from last time. Considering she spent the whole day last Friday vomiting from a stomach bug (the day AFTER the previous test), the new number is probably considerably better than what it would have been if they had tested on Saturday. Best of all, the GFR is back to normal just like you predicted.

[Susan]

I'm glad I found this thread. I have AA and PNH and may need ATG/cyclo in the future. I've already had Acute Renal Failure (ATN) from a combo of chronic long term hemolysis and an episode of food poisoning. Luckily GFR went from 15 back up to 59. Avoided dialysis. More recently 51 to 46, variable, creatinine now 1.1.

So obviously I'm wondering if my kidneys will be able to handle cyclo and for such a long time. Will be following anyone's issues with kidneys while on cyclosporine. I want to know more about how worsening renal function is handled during treatment.

Please keep posting about any kidney events on Cyclo and helpful insights into kidney concerns coming!