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  • Chemo and The Kidneys

    Posted by ladyjd on June 19, 2009 at 11:24 am

    Well, my husband’s final chemo—a combination of cysplatin and gembitacin—was on April 2. I was amazed how much the medicines changed his personality; he went from a talkative, strong man to a quiet, disagreeable, and very dependent person. Following the chemo, he returned gradually to his old self and our friends and neighbors keep commenting on how well he appears. On May 5, following a CT scan, his oncologist said he was in remission.

    During this time, he lost thirty pounds off his slender frame and has regained about half to date. We thought everything was going to be great, THEN last week he saw his local doctor for a routine exam. His serum cretinine was elevated to a reading of 2.7! Before he began chemotherapy, it was 1.1. At the time he was pronounced in remission, it was 2.1.

    We saw a nephrologists on Monday, a doctor with all the finesse of a sumo wrestler. He bluntly told Cole that he is at Stage 4 of kidney failure and nothing can be done. He blames it on the cysplatin, saying it damaged his kidneys. An ultrasound showed that the kidneys appear perfectly normal.

    Now my husband is in a complete funk, staying in bed most of the time, hardly speaking or enjoying anything around him. I don’t know what to do. Has anyone else experienced kidney problems following chemo? Is there anything that can be done?

    Thanks for your help.

    Judy

    Julie replied 15 years, 7 months ago 6 Members · 9 Replies
  • 9 Replies
  • julie's avatar

    julie

    Member
    June 21, 2009 at 7:08 am

    Judy, if possible ask the Doctor to do a depression screening. Before they gave my husband anti-depressants they asked him to answer a few questions to find out if he met the criteria. It’s harder to convince someone your fine when you are not. Using that tool the Dr. might be able to get your husband to accept some help for his mood. When people take to their bed and don’t get up they are not fine as you know. Also ask for screening for yourself. I don’t think I could have managed without being on an anti-depressant myself. My Doctor was astute enough to recognize when I needed to increase the dose as I wasn’t at a therapeutic level.

    I don’t know if your husband has the capacity to regroup in his present condition. You would know how long it might take. One thing I do know is that the will to accept and or/fight has to come from within. It is not something you can give him no matter how much you want to. Julie


    Volunteer Coordinator
    ABLSC
  • 's avatar

    Guest
    June 20, 2009 at 7:46 pm

    if at all possible i might consider that second opinion if insurance allows at the #1 Urological Hospital in the country…..Johns Hopkins
    http://www.hopkinsmedicine.org/referraldirectory/dept.cfm?DivisionID=12&DeptID=6
    Pat

  • Ladyjd's avatar

    Ladyjd

    Member
    June 20, 2009 at 10:35 am

    Thanks everyone for your encouragement. I agree we do need that second opinion, even if it is to find a doctor who is more patient-centered.

    Well, we had to go from southwest Virginia to North Carolina and Duke for an oncologist, and I’m thinking that I need to call Cole’s oncologist there to get a referral to one of that medical center’s specialists. So far, there has been no explanation why my husband’s creatinine levels rose so high following the chemo. When we phoned his oncologist, he said that the creatinine would have been out of his system by then. I am disappointed that the nephrologist had no interest in discovering how Cole arrived at those high levels.

    And, yes, he is depressed, but he is not interested in any meds to help with that. I know–I phoned his doctor about his condition, but when I put my husband on the phone, he bravely told the doctor that he was ‘fine’ and didn’t need anything. I am hopeful that he will be able to get his arms around this new development, accept it and get on with the job of dealing with it/fighting it. I keep telling him that Stage 4 is not the same as Stage 5, when it’s time for dialysis or transplant (which the nephrologist said can be done two or more years out from cancer treatment).

    As you can tell, I am the Pollyanna in our marriage. They say it’s easier to smile than frown, but these days my smile is there, held in place by duct tape!

  • cynthia's avatar

    cynthia

    Administrator
    June 19, 2009 at 9:06 pm

    Here is the link to the National Kidney Foundation it is only one of several kidney organizations on the web. If offers information on diet and others things you can do to help.

    http://www.kidney.org/kidneyDisease/


    Cynthia Kinsella
    T2 g3 CIS 8/04
    Clinical Trial
    Chemotherapy & Radiation 10/04-12/04
    Chemotherapy 3/05-5/05
    BCG 9/05-1-06
    RC w/umbilical Indiana pouch 5/06
    Left Nephrectomy 1/09
    President American Bladder Cancer Society
  • julie's avatar

    julie

    Member
    June 19, 2009 at 7:27 pm

    Judy, my husband’s creatinine levels were elevated and several of the treatments could send it higher. He could not take Aspirin or any other NSAIDs. He also went on a low salt diet. His kidney problems were caused by his diabetes but all the cancer treatments exacerbated the problems. He managed to keep his under 2. for several years.

    My sister-in-law was told she had end state renal failure and would have to go on dialysis soon. She managed to bring herself back from the brink of failure. I know she was very strict with her diet. She also contacted the national agency for the kidneys. I don’t know the name of it. But I think she got a lot of education from them about kidney failure.

    Were any other tests done by the nephrologist or his doctor or was the creatinine level the only thing. It is not definitive by itself. I know Dick had to have a 24 hours catch of all his urine. He also had a kidney function test for the flow.

    I also suggest getting a second opinion. Find a nephrologist you can get along with. Also your husband sounds depressed and no wonder with news like that. Check with his primary care physician about what type of anti-depressant he could take safely.

    Julie


    Volunteer Coordinator
    ABLSC
  • cynthia's avatar

    cynthia

    Administrator
    June 19, 2009 at 6:29 pm

    Judy,

    Through a clinical trial for bladder sparing following my dx at 47 of invasive blc I did a total of twenty trips to infusion they used Cisplatin, Paclitaxel and Gemcitabine. I failed the clinical trial and had to go to RC less than a year after finishing chemo. I had trouble during that year with keeping certain mineral levels up in my system. Calcium, Potassium, and Magnesium being the worst this was the first time I heard about the kidney damage from the chemo. I even ended up in intensive care for three days due to the levels dropping so low. My kidney function was off but not to the point it was critical until December of last year. I showed up for my usual CT with contrast and was told my function was too poor to do the contrast. By the end of February I went in to have my left kidney removed due to it being damaged by a blocked ureter. I now have added to my collection of specialists a kidney guy. I was very shocked to find out that I am considered to be in stage three kidney failure. I can’t change this but my first questions where what does this mean long term and what can I do to make sure it does not get worse? A no salt added diet, keeping my blood pressure in line as well as my diabetes became even more important. I still struggle with my mineral levels but time has taught me how to deal much better and they have not gone critical since my kidney removal.

    I have a full and happy life and do all the things I have ever done. Yes I have to be careful and yes it is another thing to deal with and yes someday I may end up on dialysis. Do I get depressed when something new like this comes up health wise sure I do but I know I have to pull out of it and go on and deal with it that is what we do. I have a blc friend who is younger than I am that has lost both kidneys to blc following her RC. She does home dialysis, works, cares for a young child and exercise regularly. Last I heard she had just had a corrective surgery a few weeks ago and was heading to Disney to take her daughter on vacation.

    The point being there is life after impaired kidney function. I would get a second opinion and find out what you can do to best hedge your bets.

    Keep us updated and remember we are here for you.


    Cynthia Kinsella
    T2 g3 CIS 8/04
    Clinical Trial
    Chemotherapy & Radiation 10/04-12/04
    Chemotherapy 3/05-5/05
    BCG 9/05-1-06
    RC w/umbilical Indiana pouch 5/06
    Left Nephrectomy 1/09
    President American Bladder Cancer Society
  • 's avatar

    Guest
    June 19, 2009 at 6:17 pm

    Judy….i’d go for that second opinion. There are many drugs that we all use such as aspirin or NSAIDS that can cause an elevated serum creatinine
    or if he is a diabetic……read this….
    http://www.chemocare.com/managing/nephrotoxicity-renal-toxicity.asp
    Pat

  • webs's avatar

    webs

    Member
    June 19, 2009 at 2:39 pm

    I have to agree with Sandy get a second opinion. We do not have the knowledge to diagnose your husband, but we can see your doctor does not suite you. He may be right or he may be wrong, but he should not be adding to your stress.

    Did he take into account that your husband just finished chemo? What sort of follow up tests did he order? Or did he just say let’s schedule a day to get that out?

    Let your husband know that we are behind him. It is normal to feel this way, but there are several on here who have lost a kidney. They are leading happy and energetic lifestyles. I am sure they will chime in.

    Please get a second opinion, you are in our thoughts.

    Webs

  • sandymc's avatar

    sandymc

    Member
    June 19, 2009 at 2:15 pm

    I am so sorry to hear this though I have been told ever since I began chemo in January 2008 that my cretinine level is too high to allow contract to be used when I have my routine CT scans. That always worries me because obviously they are not getting optimum pictures but they are adament about not further damaging my kidneys (which I do appreciate!)

    What does his Dr. mean when he says Stage 4 kidney failure? I cannot believe nothing can be done – especially since the ultrasound shows normal kidney function. Please don’t let him give up – and get another opinion as soon as possible!

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