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Co-mornidities: kidney failure

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!!

  1. Sorry to hear you are having these difficulties Amanda. Hopefully some others will chime in with their experiences. There are several risk factors with RA and treatments associated with the kidneys. This article from one of our contributors takes a closer look at this issue: https://rheumatoidarthritis.net/living/your-kidneys/.

    In addition, I thought you might be interested in this recent study finding a lower risk of chronic kidney disease for RA patients on biologics: https://www.ncbi.nlm.nih.gov/pubmed/29409725. Of course, your doctor should be able to help with guidance on treatment options. Wishing you the best. Richard (RheumatoidArthritis.net Team)

    1. Hi Amanda. I'm afraid I don't have any answers, just questions. Is your kidney oroblem from scar tissue or chronic inflammation or something else?

      To my knowledge, my kidneys are fine, but my lungs, thyroid, liver and salivary glands are turning in to scar tissue. My bloodwork only shows pisitive for RA, but used to be positive for Lupus. They are currently running tests and doing biopsies looking for amyloidosis.

      I almost lost my Methotrexate because of the lung and liver issues, but my LFT came back ok and the lungs don't look like MTX damage.

      I hope the figure out a better solution for you. This disease is scary.

      KT

      1. llo , I am sorry you are experiencing these kidney function issues. I am aware that Nsaids can contribute and are contraindicationed in renal dysfunction.I wish I knew more but Lupus definitely affects the kidneys. What does the nephrologist say ? I will keep you in my thoughts and pray

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