Drug induced kidney damage

[Mido777]

I'm inflammatory bowel disease patient for almost a decade but my disease was very controllable and manageable with medication until last year my condition started to change when i noticed the signifant froathy urine that i checked to find having a mild grade proteinuria and i had gradual increase in creatinine level from 0.8 to 1.2 although i stopped all the medics especially the PPI medicine which i much consider it the reason behind my kidney insult. the point is im very much depressed and anxious about my kidney condition as i still have the so much froathy urine with the mild grade proteinuria and i feel like it is progressing anyway eventhough i stopped the cause but as far as i learned about it once the damage occurs it usually progress and doesnt stop! this fact for me is very devastating. I'm 36 years father of two kids and I feel i dont have much time left fot them!, is there any chance my damage wont get worse over time ????

[userotc]

Common with most health conditions, AKI recovery is likely person-dependent eg link below. So attempting to manage it, should also be personalised which is consistent with healthcare provided by a qualified Nutritional Therapist so I suggest you see one (most can work remotely, if required).

He/she may also help with your IB condition. And without prescribing any (side-effect likely) drugs which I presume would suit you now!

My mum's CKD has improved massively in the past few years by adopting a NT protocol only.

Good luck and keep us posted.

nhs.uk/conditions/acute-kid...

[Blackknight1989]

Have you been to the doc? Do you have a trusted doc you can sped the time and they will spend the time to answer these questions? If not it would be my suggestion you do so.

Im ckd4 and have been since being diagnosed stage 4 in ‘96 at age 29 but I had initially a doctor who was all but incompetent and caused AKI that caused multiple organ failure and 8 months in the ICU in 1996 at age 29. Since I have maintained stage 4 with eGFR initially 22-26 now it stays consistently below 20 but we (specialist and I) that is just age related due to not being 30 anymore but now 56. Still stage 4 with eGFR averaging 17-19. That fall is fairly consistent with a normal 2/3, point drop, as disease does continue to progress, seen in a “normal” CKD patient.

If you have a “typical” kidney issue the expected age-related decline in function and shown in labs should be about 2-5 points per 10 years or so. At some point at your age (I was around the same age when I had “doctor caused CKD) . You don’t give your numbers but if you have removed what caused the insult and do not have another issue that “normally” causes acute kidney issues then you should expect a 1-2 point drop (due to normal age related decline of the organs) every 5/10 years. You MUST educate yourself on what can cause any stress on in your kidneys and at your age I believe BUT should be discussed with your trusted doctor whom should manage your medication (if you are taking any) to limit kidney decline to the normal 2-4 points per every 5/7 years (normal [whatever that means]. Then there is transplant for most (not for me though due to several other comorbities, but you should be able to avoid any significant comorbities if you pay attention any aggressively take care of your health. Additionally there are “new” pharmaceuticals being used with promising therapeutic effects on kidneys even stopping in both T2D and non- T2D patients efgr drop at stage 4.

Unfortunately they will get worse over time/ and with already having a significant insult on kidneys (as I do) you may experience more than the “normal 2/3 point drop every 5/10 years. I was consistently mid-20s eGFR in my 30 now at 56 average about 19/20. Hopefully I’ll be able to continue to limit my decline to the 2-3 point per 5/10 years and never face the issue of dialysis. I AM a worrier and obsessive about all my health issues (and pretty much everything else in life requiring “worrying”). Regardless I have learned to manage that through techniques learned from a psychiatrist about 15 years ago and expect to live a normal (hopefully dialysis free) life to about 70-75 years old (until the long-standing stage 4 probably cuts my “normal” life-span to 65/70. However, no dialysis and no real impact on the way I feel or life my life (thus-far…lol!). My best to you in your health journey!

[Mido777 in reply to Blackknight1989]

Thank you for your Reply and I’m a very much worrier too about my health. I work out regularly and trying to figure out the suitable diet for me otherwise I have some sort of poor appetite and sometimes fatigued, I’m not sure if it is kidney related or not and yes I’ve been following up with a nephrologist since the condition appeared last year in June. May I ask you if you have any degree of proteinuria too “God forbid” or any kind of apparent symptoms?

I wish you all the best, always blessed and healthy..

[Blackknight1989 in reply to Mido777]

I didn’t until 2022, leaking some now but it’s because a myriad of issues caused by COVID issues (not having the virus which I did but had no negative issues) the lockdown, having to shut down my business of 25 plus years, and a ton of other unforeseen semi-disasters that ultimately led to me, my wife and 17 year old daughter becoming homeless in May 2021 at the peak of the lockdowns. Lost the ability to pay for $22,000 a year for a middle-of the road health care plan for the family, got a diagnosis of stage 5 🪪 Idiopathic Peripheral Neuropathy most likely caused by the 26 years of eGFR at below 25. As you can probably imagine when you are worried about sleeping outside a 24 hour convenience store in the Arkansas summer, getting an eGFR test is not top of mind. Neither is reducing protein and watching potassium when you have to attend 2 different shelters for breakfast and dinner, while relying on the food bank, a thrift store pot, a charcoal grill and a box of white rice and corn to cook canned corn and white rice for lunch. I had applied for both VA help as I am a US Army serving during the first Gulf War as well as state and Social Security benefits. However, I closed my business and applied in February 2020 and this way May 2021. We are in a rural area and NO Fedral Agencies like SSA or VA were open. Needless to say it was not the best time to be a 55 homeless vet, with a family desperately trying to make ANYTHING happen to fix those issues while suffering both huge feelings of failure as a provider and a man plus undeserving of asking the VA for help because I served due to a need to give something back to the greatest country in the world, my Paternal family has had a service member in every war/conflict since the Civil War (they were from northern, KY and southern OH so on the Union side) although nog all of them were in combat nor did any make a career of the Army but I had a patriotism and strong sense of duty to serve. While I did go to our little dust up in the desert it was a walk in the park compared to the post-2001 20 years of combat where some folks spent 3/4/5 or even 6 tours of duty between both countries we we’re fighting in but they got blown-up in convoys “behind the front lines, ambushed in the Green Zones several thousands lost their lives and families lost their mom/dad/brother/sister/son/daughters. Several thousands lost legs, arms, internal organs or were severely burned. Many lost their youths at 18-22 years old and many more lost their minds to the ravages of PTSD, depression, anxiety or other mental illnesses such as many of the females serving not only had the horrors of maybe losing their lives but now face MST which is just a fancy acronym that means they were raped repeatedly in far too many cases by their superiors.

Who was I to be on a conference call or trying to make and appointment with a helper we call a VSO to file a disability case. Sure some of what I have issues with health wise are due to what is now being researched as Gulf War Syndrome and does have some scary issues like the high prevalence of ALS from service in the Gulf but again I should have been in line behind those true heros who gave so much more than I did to serve at the pleasure of the President. So again more issues of worthiness on my part, no one plans on being homeless at age 55 after the blessings bestowed on me staring with the fact I walked out of the ICU at all in 1996 and continuing through the last 15 years or so as my business was successful beyond anything I ever hoped for but just a confluence of a “perfect storm” did indeed leave us homeless for 8 weeks in a dystopian world of COVID lock down. So I was unable to see a doctor until August 1, when I went to the ER as we all did because we were fairly certain we had COVID. We all did but doctors wanted to and succeeded in forcing me into the hospital for “observation” dues to my stage 4 issues/their fear of COVID. It took me a day or two to throw enough of a fit to get released because one I being in a near capacity hospital with some really sick people in it and pitching a tent in a hospital for a long-term stay is never a good idea for overall health.

But your question was about protein in the urine and no, I had not had an issue prior to 2022 with it BUT I last had the test in 2018 so I was 4 years older at 55 not 51 I hadn't worked out much at all and had maintained a 45-60 minute aerobic workout 4 days a week with a 20/25 minute anaerobic workout or high reps low weight to trying not to completely muck-up my creatinine. Plus my stress level was redlining, I was super depressed and wondered what, if any, purpose I would now serve or hoped to serve during this super short mortal phase of our existence other than just sucking-up a more deserving persons oxygen. So yea I am now leaking protein but working on it, latest test 216 versus greater than 500 in Jan 2022. I doubt you’ll have the complete breakdown of your life during a worldwide pandemic lockdown so hopefully you won’t have those issues.

Finally a comment on worrying. It is really such a waste of the worrier’s life. I had done all the right things but I couldn’t prepare for a series of life altering issues occurring so close together DURING a period the National Government labeled me as non-essential and forced me to shutter my business. The joy of my service business the rewards i was blessed with that I was able to pass on to my family and give my kids opportunities that most of my peers couldn’t because of the financial freedom the success I was blessed with gave us. I certainly wasn’t a millionaire, WAY FAR from those kind of numbers but for rural Arkansas where I bought our 4 bedroom home for about 150k in 2011 we were blessed more than many. I consider it my life’s greatest honor to be a father especially a father blessed with two kids that insisted on doing things the right way and are just overall good people all while having that honor with my wife doing most (all) of the real heavy lifting so I could be the cool parent, well no matter what happens in the future I have had a tremendously blessed life far more than I deserve from my adoption at 9 months in 1967 to today with two terrific kids age 25 and 21 who took me and my wife who now has a grumpy 56 year old 100% disabled husband she has to play caregiver to while working full-time ( I’m sure she didn’t think of her post child-raising days of being a caregiver to eat Sunday for Farher’s day so if I didn’t get to see the sun come up tomorrow I’d have no regrets as I have been sustained and overjoyed in these extra 26 years where lits of the good stuff of life has taken place. God didn’t promise us a life of leisure and uncloudy days in this life so while I have had some disappointments and unhappiness those have been far less than the blessings and happiness that helping people as a career and being a father with two terrific kids has been awesome!

[Darlenia]

Hi Mido. Your creatinine values seem to be in the normal range. Many of us here would be over the moon with happiness to see those numbers. In my personal opinion, your kidneys seem to be fine at the moment. However, you mention having inflammatory bowel disease. Inflammation in itself can be a problem - influencing proteinuria. So, it's important to keep good control on your underlying condition. (Organs like the kidneys rarely fail on their own- there's usually "something" driving it. ) Simply return to your doctor and ask for adjustments to control your IBS - adjustments that won't harm your essential organs - liver, kidneys, etc. This may require food allergy testing, autoimmune testing and more as well as modifications to diet and medications. I suspect your poor appetite and fatigue are likely related to your digestive tract not processing your food properly, hence the foamy urine. I suspect you'll live a nice long life - simply put the horse in front of the cart, not the reverse, then keep a good eye on the road (like you're doing) and keep on keeping on.

[Hidden]

Hi Mido777,

Like you I'm IBS, but I'm also type 2 diabetic and CKD after an AKD event some years ago. I'm at the other end of the age scale with no dependents and still a mountain of worry to fill my waking hours and worry definitely does not help IBS.

As kidney function decreases with age this needs to be considered with declining kidney function.

Despite the medications I'm on being classed as kidney friendly, friends like the one's I'm taking are definitely not the meds I want to take! I have been functioning at around GFR 50 for some years until I relented and started taking BD and diabetes meds under pressure from medics and my wife. Since October last year when I started the meds my GFR has gone down to GFR38 from GFR54 and hovered around that until I had had enough of the meds and rebelled, stopping all meds except the odd omeprazole. What a surprise to have recorded a GFR50 after clearing the drugs from my body. Meantime I decided I should throw in several mini strokes just to keep everyone on their toes. So two weeks ago I started my usual meds for BP and diabetes and had some new ones thrown in for blood thinning. Results back yesterday from my blood test, GFR40, damn, two weeks back on meds and this is the result. I may as well give up my opioid based pain killers and go with celecoxib which usually robes me of 15% within the first few weeks and no chance of addiction.

Currently my IBS is full blown with me having to stop eating every other weeks to let the stomach settle down. I believe I have gotten worse since starting meds back in October. I'm under a dietitian and the gastrology dept. I have been probed, prodded, scanned, x rayed, ultrasound, given much blood and all that has been found is a slightly enlarged heart. I could have told them I had a big heart had they asked! The only thing that hasn't been done is a sampling of the stomach fluid to analyze the content. I have tried gluten free diet, lactose free diet and lately food free diet! the latter being the only one that is comfortable but not life sustaining.

I can not imagine what it is like for you with your life and family ahead of you. I can say to you don't over do exercise, follow a kidney friendly diet and try not to worry, the hardest of all the changes. The one I haven't been able to do. I don't normally read a lot but since I have had these health issue dumped upon me, I have read and read to understand what I'm going through so I can tell my medics when I think they are wrong or right. Medicine is not and exact science, humans are not all the same and Doctors find it difficult to deal with multiple health issues in one patient unless they have specialised.

I watch my urine each time checking for froth, which is always there now, and colour. Colour of light straw to clear indicates your kidneys have done their job. Darker colour and you need to increase the amount of fluid you drink as the kidneys are not being flushed enough.

I think you will find life can go on with CKD and often quite well at that, with a few lifestyle changes and most things in moderation who knows what you could achieve.

The D in CKD/AKD is not for death, it is disease something that can be managed with care.

So take care.

Cheers