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KIDNEY DISEASE AND PREDNISONE August 26, 2009

Posted by wmmbb in Life Experience.
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My kidney disease, glomerulonephritis (MPGN Type I), has progressively become worse since December 2006.

I am not sure about the prognosis, but believing in the power of mind over matter, I hold a tenuous hope  my condition of glomerulonephritis can be turned around . In the meantime I am dependent on medication. I have just done a comparison with my 92 year old friend, Ernie,  and I outdo him in tablets and other medication required to be taken.

Chronic glomerulonephritis is described as a progressive disease that takes hold without evident symptoms until it reaches a acute development. In my case the kidney problem (and a blood anomaly) found after looking around for possible cause of an enlarged spleen. My spleen was surgically removed and the biopsy did not provide guidance as to the reason for the condition.

Now I have reached the stage where I have begun coriticosteroids tablets (as distinct from anabolic steroids). My medical advisers and I have delayed this action as long as we could, but the advice now is that there is an intervention now to try to reduce the inflammation of the kidney filtration operation (the glomeruli). Otherwise the disease will produce deterioration that makes intervention irrelevant with consequences that would be irreversible.

Ernie is very amused by my telling him that Prednisone is also used for dogs. Some people seem to have been on this drug for some time, but the side effects are a concern to say the least. I am told there will be side effects most likely weight gain, bone demineralization and increase suseptibility to inflection and bruising. My GP tells me to stay away from sick people, yet I am going to hospital to have an Aredia injection (plus a bone density test).

It seems that prednisone is also a “psychotropic drug”. This could be fun or not. DrugLib.com advises:

Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.

The critical factor is the pre-existing condition. Please keep monitoring this blog for further developments. I am confident in the belief that mental deterioration is evidenced in written expression. As has been correctly observed writing (and particularly typing) “connects cognition, language and motor skills“. I have a known (and acknowledged) pre-existing condition of failure to spot typos.

The broader point I want to emphasis the management of this disease is not just a matter of getting access to a hospital emergency ward, but rather longer term medical observation over years otherwise the disease becomes catastrophic. There are no doubt other examples. Another medical issue in this case, as with cancer for example, is early detection and perhaps prevention. I suppose it could be argued that the physical and mental health of every person is a public good, but what are the boundaries for the private and public realm?

ELSEWHERE:

“Educate before you medicate” sound like good advice. At least there are positive stories. Clearly, the best advice and counsel is that which is understood.

I am reminded on the climate science “debate” which is characterized by disfigurement of facts and dishonesty in presentation. As citizens of democracy we take an implicit pledge of good faith, which allows for misunderstanding and error but not deliberate lying. Such a pledge would put many in the public relations industry out of business. We have a social and democratic problem when lack of ethics becomes a condition for success. Capitalist and corporate myopia predispose to such an outcome.

Note:

I had better sort out the chronic/acute distinction next time I see my specialist. I suspect that chronic is a long term condition and acute is at the point of kidney failure.

UPDATE:

Now I have spent three hours at the hospital have an Arednia drip, which is intended to block the decalification of the bones by Prednisone.

I have updated now (10.10.10) to a more exciting drug, while still on a reduced dose of prednisone. The new medication is cyclophosphamide, a carcinogenic drug used some forms of cancer.

UPDATE: 7th December 212

Prednisone is now a poor memory. It did not prove successful. Last year I upgraded, which to say I was put on a drug with more serious side effects, cyclophosphamide. After more than a year this drug has worked well enough to reduce the protein leakage in the blood, indicated by the albumin level and edema, indicted by swollen legs, ankles and feet. These latter overt signs have gone now, but with reduced dosage of cyclophosphamide, I still have a consistent level of protein leakage, although my blood pressure on Wednesday was 125/75 ( I omitted to get the heart rate). Since blood pressure, like temperature, is a derived variable, it probably should be measured more regularly to be able to draw provisional conclusions.

The thing is that now my specialist has put me on a new drug – Imuran – which I understood is not as strong as cyclophophamide. It turns out the generic name for the drug is Azathioprine.

Comments»

1. Judith Ellis - August 27, 2009

I am thinking of you, wmmbb.

2. Gadolinium Contrast Agents and the Link to Nephrogenic Systemic Fibrosis (NSF) | Mesothelioma - August 27, 2009

[...] KIDNEY DISEASE AND PREDNISONE « DUCKPOND [...]

wmmbb - August 27, 2009

Askimet defined this link as spam, but it may be relevant to people with kidney issues who may read this post. You make your own judgment on these matters.

3. wmmbb - August 27, 2009

Thank you for your thoughts, Judith. I was very disinclined to take this path,but since the previous attempt at cure did not work, this seems to be the possible, if far from guaranteed, way to reducing the problem. My renal physician has always taken the view that my role in keeping an eye on what is happening to me is very important.

Aside from the consequences of side effects, I reflect on my good fortune which is not of my doing. I get access to good medical care, including two doctors with ph.ds in medicine. I do not have to worry about insurance companies or the threat of dispossession. There are costs. I have to paid to see my GP and pay for medications, which I do not minimize, but they are not barriers to entry.

I do not live in perfect world, nor have I acted perfectly, but it is better than it might otherwise could be. After all, as I said the other day in one of my renal consultation the other day: “You can only die once”.

4. Col - August 28, 2009

I can understand the weight of this decision to start with the prednisone. I am hoping that the positive effects tip the scale in your favour. Please know my thoughts are with you, wmmbb.

wmmbb - August 28, 2009

Thanks Colleen.

It is important to keep in mind that there could be positive effects and it could be successful. If things go wrong, as least I have access to help.

5. KIDNEY BIOPSY RESULTS « DUCKPOND - December 8, 2009

[...] The first trial of medication has not worked, instead my kidney condition has deterioated. Now I am on prednisone. [...]

6. Cliff Sterling - February 25, 2010

After being continually diagnosed as being in the fourth stage of kidney disease for approximately eight years, my last test reflected thrid stage kidney disease. Since I have been taking Prednisone for another medical condition, is it possible that this drug has dramatically improved my kidney function? And I do wonder if my kidney condition may have a diagnosis that my kidney specialists, over the years, did not find. I shall appreciate any information that may be offered.

wmmbb - February 27, 2010

The prednisone seems to have reduced my kidney problem to the point where the observations are flat lining. My specialist said that prednisone can cure the disease with about 40% (if I remember correctly) of cases. As it is he is gradually cutting back on the prednisone and now I am on 30mg per day.

He also says that there are no reliable way to cure this disease and the options then open up to chemo-therapy type drugs that have significant side effects.


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