Eliquis and onset of Declining Kidney Function

[Phantom1234]

Just wondering if anyone has seen a correlation to Eliquis or similar drugs and declining kidney values in bloodwork? All normal values including creatinine/bun/egfr and within 6 months of starting this drug all values declined; Kidney doc & cardiologist say don't think related but I don't see how values change out of the blue

[Hidden]

Hi, I always check out all prescribed meds at the doctor's office with drugs.com prior to authorizing them to call it into my pharmacy. I've included a direct link to the page for Eliquis below. From what I can read I would have a lot of questions about its efficacy. Read it for yourself and see if you can come up with questions to ask about your specific condition. There are times when one health issue has to take precedent over all others and this may be a situation you have to decide on the lesser of two options.

drugs.com/eliquis.html

[Phantom1234 in reply to Hidden]

Thanks. I've tracked all my labs with dates 2 years prior to starting this drug and kidney issues evident within a few months of start; shared this chart with both docs; we disagree and both feel it's not a side effect so my question to them is do I choose to destroy my kidneys or take eliquis for stroke prevention. I'll be having this talk with both and thanks for link which I'll review as well.

[Hidden in reply to Phantom1234]

I've had to make a similar choice. NSAIDs are not good for someone with CKD but I take an aspirin regimen for a heart issue even though it may harm my kidneys. I can live with bad kidneys and do dialysis but not with severe heart issues. If you have the chance, check for a generic or alternative that may have a less negative impact on your kidneys.

Has your nephrologist determined what the root cause of your CKD is if, in his opinion, it's not related to your medication? They are obligated to explain your health and options, along with risk factors, to you.

Best of luck.

[Phantom1234 in reply to Hidden]

Well, may be looking for a new nephrologist too; all he's done is order labs about every 3 months; no idea as to cause except to state perhaps from prior ct's w/contrast; wanted me off hctz which i've taken for many years with no kidney issues; no guidance on whether kidney diet was appropriate either. Just disappointing! Are there tests I should ask for to determine root cause?

[Hidden in reply to Phantom1234]

Usually, an ultrasound or a biopsy would be diagnostic tests to be used. In my case, it was an ultrasound to confirm my diabetes was the cause. You need a supportive care team of physicians to help you deal with escalating health issues. Keep us informed.

[Phantom1234 in reply to Hidden]

I agree. Will make a plan and insist on getting answers from these doctors. I find that getting physicians to coordinate care is almost impossible. They like to stay in their lane...

[Hidden in reply to Phantom1234]

Just my opinion here but when that happens it falls on you to become the decider on your health care. Learn all you can on your own, ask probing questions, and be sure you understand their answers. Ask what your options are and where each option can lead you. Speak to your family or someone you trust and make your decision. If your insurance allows it, make the changes needed to your team. It's your life and your health.

Keep us posted.

[Phantom1234 in reply to Hidden]

Thank you so much for your input; I'm not shy about asking questions and usually research ahead and show up with a written list to discuss. I do feel the need for a "coordinator" doctor, maybe my gp to discuss plan with but currently looking to replace that doc too. I'll post again after my appts. Thanks again,

[Hidden in reply to Phantom1234]

Don't lose hope. Remember, the best coordinator for your healthcare is YOU. Keep doing your research.

Keep in touch.

[Bond-007 in reply to Phantom1234]

Not a very good trade off. There has to be a way to get both benefits. Is there a way to get stroke prevention plus good kidney health? Would an internet search on both criteria come up with something, like Vascepa, Losartan, Valsartan, fish oil, mediterranean diet, whole food plant based diet, etc? Its a puzzle piece - there has to be something that fits in. Mr. K recommends aspirin. Can you do that? Maybe so, perhaps at low dose, and not every day, but every other day or every 3 days, if you have to take something. But be careful - you can’t stop aspirin cold turkey after you have been on it a while and especially if you are older or have a heart valve or other cardiovascular condition as it can cause a COX2 rebound and prothrombosis leading to a heart attack or stroke with high risk after 30 days off aspirin. The ischemia can affect the circulation to the brain and the kidneys if you stop aspirin suddenly and do not restart by 7 days. Must restart it by 7 days! But Aspirin can also cause gastritis, stomach ulcers and may eventually lead to internal bleeding in the upper GI tract as a result, either occult or gross, as in the case with black stool. So once on it you can’t live with it and can’t live without it, but it can be managed, e.g. by taking PPIs to reduce peptic ulcer risk and gastritis. Why gastritis, because COX2 is also involved in producing the gastric mucosa that protects the stomach lining from HCL, hydrochloric acid that is produced in the stomach to digest food. So aspirin inhibits COX2, leading to less mucosal protection in the stomach, leading to peptic ulcers that can bleed as a result, though it is usually slow and will give warnings so you can measure Hg and see if you have black stool, or fecal occult blood. PPIs like aciphex inhibit the acid in the midst of reduced mucosal protection, preventing ulcers from NSAID (e.g., aspirin) use. If so, you can reduce or stop aspirin for a little while. Is there a diet that helps both the heart and kidneys without any risk that aspirin represents both when used and when stopped? Maybe there is and if so it is the holy grail of blood thinning. We are thinking long term here. I’m no Dr, that’s for sure, but I learned the hard way via the school of hard knocks. You don’t want to do that. Listen to Mr. Kidney about attitude toward your Drs and do your own research if you can and use common sense and trust your feelings and be proactive and don’t put all your trust in one Dr. or protocol, be flexible. "May the force be with you."

[medway-lady]

In the UK its Apixaban and I've been taking Riveroxaban since 2014 with no issues at all . I had an AKI in October 2018 but not down to the Riveroxaban and the dose was adjusted for clearance rate. I understand it takes priority down to risk factors so have never worried about it.

[Phantom1234 in reply to medway-lady]

Seems all these drugs can affect different people in strange ways. I do believe these issues are real for each of us and doctors would be better to listen to their patients more.

[medway-lady in reply to Phantom1234]

The same applies to all medications though. I have RA and Riveroxaban doesn't affect RA meds. it also has the side effect of preventing me from getting more very life threatening pulmonary blood clots. I went from 89% kidney function to 8GFR in a couple of weeks with no warning despite monthly blood tests by the RA team it happened so suddenly it shocked everyone. I have to add I had very good treatment and function has recovered to 26% since. I agree doctors should listen but mine did and saved my life with prompt action although I have no heart issues just 'sticky blood' and Rheumatoid Arthritis. I see a Nephrologist and am under the Renal Hospital so all is well really, it probably won't get much better but its ok.

[Phantom1234 in reply to medway-lady]

That sounds very scary -- so the riveroxaban was what caused decline in kidney function? I agree blood thinners are necessary when discussing blood clots, etc., but it just seems that they give you one pill for a condition which causes another condition then another pill to treat. A few months ago I was given a beta blocker for blood pressure; 2 weeks later blood sugar was increasing (I'm not diabetic) so had to stop. fortunately the dr. ordered blood work 3 weeks into the drug to check.

[SkiingSailor]

I was put on this drug and I believe it was the beginning of my kidney problems ! I halved my dose- without permission- then cut it altogether when I saw a consultant cardiologist and he said I didn’t need it. So... get another professional opinion, before your kidneys really start screaming. Good luck.

[Phantom1234 in reply to SkiingSailor]

I agree with you! Just met again with my nephrologist last week; he still insists that this drug rarely causes declining kidney function and only rarely in some people. Well, I am that person; Cardiologist does not want me to stop because of AFIB and stroke risk or even cut in half; still researching options and looking to find new kidney/cardio docs for 2nd opinion. Last blood work shows all numbers stable; no increases to be concerned about

[Raclette in reply to Phantom1234]

It is a nightmare getting different advice - stay in tune with your own body, sometimes your body tells you what is right.

[barneyfrances]

Hello Phantom1234.......I have the same problem. diagnosed with AF in2018 and have been taking apaxaban .... up till then my kidney function test were always normal, now after 2 years have declined and am at stage 2 GDR , doctor says it's a coincidence, but I'm not convinced. Where do we go from here - would love some concrete answers or better still solutions !!

[Phantom1234]

Unfortunately my docs usually just shrug their shoulders -- in their opinion it's a "lesser of two evils" -- do I want stroke protection or to be right about kidney decline; I'm told eliquis is best one to avoid bleeding issues of these drugs then offered the option of trying another one of these that may be better for my kidney issues (my research of all these says that eliquis has best kidney protection)! my AFIB is paroxymal and occurs about every 5+ months and my understanding is stroke risk occurs after an afib episode for 30+days....hard to know what to do!