Low gfr

[jeannette65]

I was recalled to my gp after diabetes test. That was ok but he said my kidney function was down from 91 to 40 in the last year. Now sending me to hospital for tests. I have GCA and RA so have been on very high steroids Surely this is the cause? Why has this not been mentioned before? I'm really confused and worried as I can't leave off the steroids. Any advice please.

[Celtic]

Jeanette, you haven't said how long you have been suffering from GCA but it's quite possible that the inflammation of the illness itself could be responsible for the reduction in your kidney function, especially if the inflammation was lurking for some time before diagnosis and steroid treatment.

I spent a year with undiagnosed, therefore untreated, PMR (a linked illness to GCA) and towards the end of that year I was diagnosed with CKD3, with an eGFR in the lower 50's. A short while later, I was diagnosed with both PMR and GCA. The jury is out as to whether the untreated inflammation or a few months on low dose Ibuprofen, or both, resulted in the diagnosis of CKD. Having only one kidney I may have been more vulnerable.

I doubt the steroids are responsible as I know that steroids are, in fact, prescribed for certain kidney problems.

Diabetes can lead to reduced kidney function, and I wonder as you have mentioned having a diabetes test whether you might have a problem in that area?

Raised blood pressure can also cause reduced kidney function, and that is something that is aggravating my kidney function these days - certain blood pressure medication can also adversely affect the kidneys.

Good luck with the hospital investigation. Meanwhile, drink plenty of water, reduce your intake of salt and have plenty of exercise.

[jeannette65 in reply to Celtic]

Thanks Celtic for your reply. I have had GCA for 17 months have reduced steroids from 60 now on 4/3 reducing every 8 weeks. Had two big steroid infusions at the beginning that left me with 2 fractured in the spine. Also I am on toxi monthly infusions. My gp was more concerned with the drop than my rhemy he said it wasn't linked to the GCA. So now don't know what to think. Go to hospital on July 7th so don't think it's urgent.Hope you are feeling o k .

[Celtic in reply to jeannette65]

Jeannette, it sounds as though you have done very well to reduce your steroids from 60 to 4/3 over just 17 months, no doubt helped by the Toxilizumab. I assume the latter is prescribed for your RA as I didn't think it was being generally prescribed yet for GCA, although I know that results following a large trial into its treatment for GCA are expected to be published shortly. Is it possible that the Toxilizumab has had an effect on your kidney function? I haven't read anything that suggests that - it is usually the liver that has to be monitored.

What rotten luck experiencing two fractures of your spine. Had you previously been diagnosed with thinning of your bones that made you more vulnerable to the steroids. I know someone who has experienced something similar but her fractures were put down to the bone protection drugs prescribed alongside the steroids rather than the steroids themselves.

I do hope that your hospital investigation will come up with some treatment that will at least stabilise your kidney function.

[jeannette65]

I was on rituximab infusions when l got GCA and they changed me over toxi for the GCA. Personally I think the rituximab was better for my ra and have told my Rheuemy so. He said that he had to treat GCA so l had to change. He did have to apply for special funding for it and was refused the first time but got it the second.I had no problems with my bones until the large infusions and they couldn't understand why my legs had just gone. Another Mir scan showed the fractures. What tests do you think they will do at the hospital?

[Freckle1000]

Hi jeannette,

I'm hoping some of the issues raised when you posted have been resolved !

I have Systemic Lupus, with Lupus nephritis. (Had it for 34 years) I have never heard of steroids hurting the kidneys. But long term use of (prednisolone) can make you vulnerable to developing osteoporosis and fractures. Alendronate Sodium is good for maintaining bone density and in some cases - including my own - healing some of the osteoporosis.

Personally, I have found Micophenolate Mofetil a miracle drug for protecting the kidneys from my over zealous immune system. It is also a steroid sparing drug. I know Micophenolate is the drug of choice for Lupus Nephritis and given RA can behave very similarly - perhaps this drug could help protect your kidneys if this is whats going on ?

Hope you've seen a Nephrologist by now ?