kidney problems with cyclosporine

[JEZ]

I am in my late 50s and diagnosed with AA several years ago. After two years of successful treatment for aplastic anemia with Neoral, I have developed kidney nephropathy due to the cyclosporine. I am between a rock and a hard place because I need the cyclosporine to allow my bone marrow to work but the treatment is toxic to my kidneys. I would like to hear how others have dealt with this problem.

Thank you!

[Hawaii Bill]

Hi JEZ,

I look forward to the responses, because I am also on a high dose of CsA and so far my creatinine counts have been really good, but you never know...

If you don't mind sharing, how did the kidney problems start to show? I'd like to know if and when I start to have any problems. TIA

Bill

[JEZ]

Bill,

My creatinine has been steadily climbing since last July. My baseline is 0.7 and it has climbed to 1.6. But the worst of it is the GFR calc on the lab report which indicates kidney filtering function (if I understand this properly). My norm before treatment in Jan 2007 was 87%. I just found out from a nephrology consult that last July it was 49, in Nov. it was 42, in Feb it was 39 and at the end of April it was 33. I just went to the nephrologist to figure this out. She says it is from the cyclosporine. When I called my regular hematologist, however, she was not so sure. I am very concerned right now because I feel a sense of urgency about this (apparently at 20% one needs dialysis???) but the two MDs have not yet spoken or consulted with me about a course of action. I do not believe there are a bunch of symptoms until one is in stage IV kidney failure. Right now the nephrologist says I am in stage III. Hope this at least helps you some. I am just learning about it and may not be completely accurate on it all. Hopefully some others on the forum can expound on this as well.

JEZ

[Hawaii Bill]

Thanks very much for the info. I will ask my doctor about the GFR. No harm checking. Dr Paquette at UCLA has only asked me about my creatinine level (I check in with him every couple of months). It has stayed around 0.8 since I started the 200mg bid. I give thanks for that!

I wish you the best of fortune with yours!

[JEZ]

Hi all,

Because of the kidney toxicity of cyclosporine, my doctor wants to start me on Imuren. She says I will start it immediately while taking cyclosprine 2 more weeks (to bridge it in), then stop the cyclosporine and just be on the Imuren, 50mg (not sure if she said Qd or BID)... Has anyone used this instead of cyclosporine for AA? I just got my counts up to the remission level using cyclosporine (Neoral) for 2 years and sure don't want everything to tank. On the other hand, I can't allow my kidneys to tank either... anything you can share about Imuren drug therapy for AA would be greatly appreciated!

JEZ