Prednisone and kidneys

[Charlotteab]

I was diagnosed with PMR in July 2023 and have been on prednisone ever since, although I have tapered down from 15 mg a day to 13 mg, and will be tapering further down to 12 in the next week or so. My last bloodwork showed higher than normal creatinine levels (104), and a glomerular filtration rate of 50. I know that prednisone can affect the kidneys, but my doctor has never contacted me about these results, so I assume he's not concerned about them. I only found out about them through accessing my own results through the lab. Should I be worried?

[PMRpro Ambassador]

It very much depends on a lot of factors - were you dehydrated when they took the blood sample, had you eaten a lot of protein for dinner the night before are just two factors. Were there other things like protein in your urine? Is this the first time? They only worry if the figures remain abnormal for 3 months in a row and a reduced eGFR is to be expected as you age though.

kidney.org/sites/default/fi...

I'm sure your GP will contact you if he is concerned at all.

[Charlotteab in reply to PMRpro]

Thanks PMRpro. I've had two rounds of bloodwork done since last September, and this is the first time the creatinine and eGFR levels were off. I can't remember what I had for dinner the night before this last test. It's possible I may have been dehydrated -- I know I don't drink as much water as I should. I don't see the doctor again until July now. In the meantime, I'm watching my salt intake and will try to remind myself to drink more water.

[PMRpro Ambassador in reply to Charlotteab]

The worst aspect tends to be that you don't drink as much before you dash out for the blood appointment! But your docs obviously aren't concerned.

[Koalajane]

at my last diabetic review my eGFR was down. I have to say I wasn’t surprised. It was a warm sunny afternoon and I had been dashing around with no time to drink. I had to go for another one 3 months later and I had an early morning appointment and made sure I had drunk plenty of water and looking at my results online there was a note saying stable no concerns

[Charlotteab in reply to Koalajane]

That's good to know -- glad your eGFR stabilized! I'd been someplace else before I went for my bloodwork and had only had a cup of tea to drink since earlier in the morning, so it's possible I was dehydrated.

[Koalajane in reply to Charlotteab]

I also find I am better having the blood test early morning than late afternoon

[Charlotteab in reply to Koalajane]

Good to know -- I had mine done after lunch. I wasn't told to fast.

[DorsetLady PMRGCAuk volunteer in reply to Koalajane]

No choice in our surgeries in most of Dorset, - have to be done in morning - collected between 12noon and 1pm to go Path Lab in local hospital.

[Charlotteab in reply to DorsetLady]

We can go anytime -- I tend to go early afternoon because it tends to be a bit quieter then, which means I don't have to sit for ages in a crowded waiting room.

[PMRCanada]

I get bloodwork done monthly as ordered by my rheumatologist (I’m on pred and methotrexate). I get my results online with LifeLabs. The odd time, perhaps once a year, one of my results shows something not in range. The next month it’s resolved on its own without intervention. So I’ve learned not to be too concerned and trust that my doctor would contact me if they were.

If it will give you peace of mind, you could always contact them and enquire.

[Charlotteab in reply to PMRCanada]

Thanks PMRCanada! My doctor told me to come back in July, so I likely won't have bloodwork done again until then. I guess he feels there's no need for me to come back sooner, unless something else happens with my health in the meantime. I don't have a rheumatologist. I asked my GP about it at my last appointment, and he said there likely wasn't anything a rheumatologist could add to what we already know.

[Iamfedup]

Doctors generally ignore kidneys until they become a problem! I had a sort of mot that I paid for and was told to my amazement that I had kidney disease and to see my doctor! On seeing him he was very blasé and said I’d had it for a few years😱I think you will find the same

[DorsetLady PMRGCAuk volunteer in reply to Iamfedup]

Not sure they ‘ignore’ kidneys, but there are a number of stages of CKD, and as you get older your kidney function does deteriorate naturally. Plus some medications- Pred being one -can affect that.

Your usual doctor obviously decided that was the case, but agree it should have been mentioned to you… mine was when I first start Pred 14 years ago - but it’s not got any worse after 4 years of Pred nor the time elapsed since.

[Iamfedup in reply to DorsetLady]

I am aware of three other people who were not told. And unfortunately mine deteriorated further whilst on Pred for four years

[DorsetLady PMRGCAuk volunteer in reply to Iamfedup]

Not good...

[Karenjaninaz]

I found dehydration with greatly affect kidney tests. Once my EGFR was in the 40s I want for a repeat test a month later but drank plenty of fluid in the days before= normal result 70.

[Charlotteab in reply to Karenjaninaz]

I'll remember to drink plenty of water before my next blood test!