Newbie with concerns......help appreciated.

[hopalong_too]

I have never posted on the kidney board before. I have hypothyroidism and take medication for it. I also have arthritis confirmed by bone scan in bilateral shoulders, bilateral elbows, bilateral wrists, bilateral hips, bilateral knees, bilateral ankles, cervical and lumbar spine. Also had it in both MTP joints in my feet but had the joints fused to eliminate the pain. Main symptoms at this point are pain and extreme fatigue. I also have high cholesterol 225 but doctor says not to worry as HDL is high! And low Vitamin D.......always low but taking 5000IU daily......the level just will NOT stay above 32! (Usually averages 20-25).

Now my problem. I am female/Caucasian/52. The rheumatologist was not interested in me so my GP is treating me with Celebrex 200mg twice daily and Voltaren Gel. It is the first thing that has helped. I have previously tried Etodolac and Diclofenac Sodium. My RBC are at 4.01 (4.0-5.3) previously 3.98 (4.0-5.3). The GP said something was not quite right with my last blood test and I wasn't sure what she was talking about. Now I see that she is talking about my Creatinine and GFR. It was .7 (Creatinine) in spring of this year.....GFR 93%. Then a few months later Creatinine (september) Creatinine .89 GFR 71% Now this month Creatinine .93 GFR 67%. I have been complaining about having to urinate a lot and especially at night.

I had a pelvic ultrasound done a while ago and it showed tiny renal cysts but I was told it was nothing to worry about. Has anyone had a problem with declining kidney function from taking Celebrex (or other NSAIDS)? Should I worry at this point? If not, when? Could it possibly have anything to do with the renal cysts? Could the lowish RBC be due to the decline in kidney function (I have read that erythropoietin has to do with kidneys)? There is a history of kidney cancer and a stronger history of bladder cancer in my family. I have not heard anything further since my last blood test from my GP. Any insight would be appreciated. Thank you, Hoppy

[Coravh]

Yes, nsaids can cause a decline in (or even significant damage to) kidney function. At this point, your creatinine is still within normal limits, but it would be good to keep an eye on things in case it progresses. You are correct, epo is a kidney hormone that assists in the production of red blood cells and hemoglobin. it is given via injection to many kidney patients to treat anemia.

Currently, you seem to be in a situation that needs monitoring, but nothing more. Is it possible for you to decrease the nsaids? This is always a good thing where kidneys are involved.

[hopalong_too]

The Celebrex is the first NSAID that lessens the pain and allows me to function. Are there any pain relievers that do not damage the kidneys?

Is it possible that the renal cysts found on abdominal CT have anything to do with the lowered GFR? At what point would a doctor consider rechecking that?

At this level of GFR, would the RBC production possibly be affected or would the low RBC be from something else altogether? What do you mean by "needs monitoring"?

I really appreciate your help as this is all new to me.

[Coravh]

Originally Posted by hopalong_too

The Celebrex is the first NSAID that lessens the pain and allows me to function. Are there any pain relievers that do not damage the kidneys?

Is it possible that the renal cysts found on abdominal CT have anything to do with the lowered GFR? At what point would a doctor consider rechecking that?

At this level of GFR, would the RBC production possibly be affected or would the low RBC be from something else altogether? What do you mean by "needs monitoring"?

I really appreciate your help as this is all new to me.

Nsaids are a funny subject. Some people are sensetive to them. So not even the max dose may cause damage. Other people don't have problems. They cysts may or may not be affecting the GFR. That is why it is so important to continue to monitor your kidney function. At this point, a couple of times per year is probably sufficient, but I would check with the doc.

There is no set time line with kidney issues and you can't equate a gfr with a level of anemia. I had anemia very early, but other symptoms occurred very late.

By "monitoring" I mean having follow ups with the docs and labwork drawn periodically. How often will depend on the doc, but once or twice a year will probably be what is suggested.

[hopalong_too]

Thanks Cora. My doc is great then.......I will have blood drawn again in 6 weeks.