By Amanda Kohl
Has anyone else been diagnosed with Chronic Kidney Disease or Kidney Failure as a result of long-term NSAIDS uand/or cortisone steroid use to treat their RA? I’ve been on a prescription NSAIDs for at least 7 years, not to mention the years of OTC ibuprofen taken for years prior to RA and OA diagnosis, and at least 3+ years of a daily prednisone dose to bring my RA symptoms under control, with frequent cortisone injections for extreme inflammation in various joints, over time. Last summer I was referred to a Nephrologist because my kidney function was extremely low. My GFR (glomerular filtration rate) was 36. Normal range is greater than 90, and below 20 they start dialysis and begin discussing kidney transplant. With immediate discontinuation of NSAIDs and prednisone, I’ve managed to bring my GFR back to mid-50s range, which is considered moderate kidney failure. If my GFR continues to decline, the next medication to go will be methotrexate. While I’m grateful to have caught the issue before it became severe enough to result in extreme treatment measures, my body acutely feels the result of not having the baseline medications necessary to treat the chronic inflammation of RA! As a result of living without daily NSAIDs, I now rely on higher, more frequent doses of Oxicodone, an opioid pain reliever, which has no Antiinflammatory properties. It’s a catch 22 and many days I am torn between the need to reduce the inflammation which is the basic cause of RA pain and the fear of loosing kidney function which would require such drastic treatment measures!! From the time I began my RA treatment regimen with MTX and Biologics my Rheumatologist has stressed, and I’ve read numerous articles which stress the importance of monitoring liver function due to the metabolism of these medications. However, even though I’ve found a few articles that talk about the affect of RA on the kidneys as one the organs of the body in the disease process, I can’t seem to find much information related to the affects on the kidneys as a result of the medications. As NSAIDs and cortisone are baseline medications in the treatment of RA, I can’t be the only one diagnosed with this co-morbidity. I would truly appreciate any information available and to hear from my fellow warriors that have experienced this issue!! Thanks much!!