Farxiga for safe for elderly with CKD?

[Mippy13]

I am over 75 y.o. and have a GFR in the high 20’s. I am considering taking Farxiga.

Not sure if the risks are worth it?

The Farxiga studies say that the risk of acute kidney injury is higher for the elderly and for those with renal impairment but, it’s not clear how big of a risk.

Nephrologist is recommending against it but question whether they are being overly conservative and whether they are familiar with this medication at all as I had to ask them about it.

Anyone have experience or knowledge of using Farxiga with older patients and/or patients with lower GFRs (20-30’s)?

Need some advice! Thanks!

[Bassetmommer NKF Ambassador]

HI Mippy,The reason for the warning is because of dehydration. Elderly are prone to not drinking as much as they should and of course we all know how important hydration is for CKD. My husband started on Farxiga this past August. He had unstable diabetes. It has really helped to keep his numbers level, no big spikes. His A1c is down from 8 to 7 and holding. His GFR is 3 b and also holding. The thing with STLG -2 is they are cardiac protective, which he needs. And he is 71.

There is reluctance with some nephrologist with the new drugs. I am on a GLP-1, Ozempic and I had to fight for it. So simple, once a week and my glucose is so steady and I am using less insulin. AND my GFR went up and my creatinine went down. I cannot say it was totally from the drug though. You really have to up your water intake with these drugs.

[jodaer in reply to Bassetmommer]

I've not taken it yet but my nephrologist wants me to start it. I mentioned side effects and he said all meds have side effects. I'm 78, T-2 diabetic, eGFR 55,

[Bassetmommer NKF Ambassador in reply to jodaer]

My husband has had no side effects on Farxiga/Forxiga. The GLP1...... that has had side effects for me.

[Mippy13 in reply to jodaer]

Thank you for replying. It would be wonderful if is able to stabilize your GFR as it is still relatively high. Good luck and please keep us posted?

[Mippy13 in reply to Bassetmommer]

Thanks so much for your thoughtful response. I’m glad to hear it’s working well for your husband and that you are a strong advocate for yourself.

It’s an interesting point you make about the elderly being prone to not drinking enough water. It makes sense and it’s reassuring if that’s true since at least it’s something that’s controllable. I’m curious… Is this your theory or did your doctor tell you that dehydration is reason the elderly are at higher risk of adverse events when on Forxiga?

Also, did your husband experience a dip in his GFR in the first few weeks of taking Farxiga? I read that this is typical but after a while it stabilizes. But it seems a little scary to watch a dip and hope that it comes back!

Thank you for sharing your advice

[Bassetmommer NKF Ambassador in reply to Mippy13]

It is common knowledge and I also worked in health care, that the elderly are prone to dehydration. Our nephrologist warned about it when she prescribed our drugs. You see in this link it mentions urinary tract infects also, which can be caused from not drinking enough fluids also.

healthline.com/health/type-...