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questions regarding prograf and toll on kidneys...

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Posted 12/10/2013 8:33 PM (GMT 0)
I posted this question on the kidney forum but wanted to see if anyone here can share any advice. My mom is 7 months post liver transplant and takes prograf 2.5mgs 2x daily in addition to other medications. Our Transplant Coordinator has always stressed that the prograf can take a toll on the kidneys. My mom is also diabetic and takes insulin. Thankfully, her diabetes is under control.

Can someone help me interpret these recent test results?

December 2013

URINE Results:
Urine malb 38.8
Urine creat 80.6
Alb/creat ratio 48.0 HIGH (normal range 0-24.9)

BLOODwork:
Creatinine 0.85 (normal 0.52-1.04)
Bun 30 HIGH (normal 8-25)
Bun/Creatinine level 35.3 HIGH (normal 5.4-33.0)

I noticed that my mom's BUN is slowly creeping up...it was 25, 22, 28 now its 30!

What do these results mean? My mom's endocrinologist ordered these tests but isn't back in the office until later this week. Just wanted to see if I could get a jump start on what these number mean?

Thank you so much.
Posted 12/10/2013 9:08 PM (GMT 0)
WD, I am not a doc and don't really interpret labs but for their definitions and that sort of thing.

It seems some kidney functions are in normal range and some are a bit high. Mike sees a nephrologist every 4-6 months, which is covered by his insurance. Yes, prograf is hard on the kidneys. But if they ever fail, he buys time with kidney dialysis. But for now, I bet your Mom, like Mike, is okay. There is no dialysis for livers, so they take the prograf!

They tried Mike on the kidney sparing antirejection med Rapamune, but he did not tolerate it well.

His nephrologist said many do not. I posted this question on a TP forum and some did have good luck with the Rapa.

This is a matter for your TP coordinator and nephrologist to work out.

How are YOU today?

Hugs,
Posted 12/11/2013 2:16 PM (GMT 0)
Hi MamaLama.

I spoke to both our TC and the Endocrinologist yesterday. Endocrinologist was actually in the office. It's funny bc they both called within a few minutes of each other. Both of them gave me the same information...the elevated BUN typically means dehydration, so my mom needs to drink more water. She already does, but needs to increase it some more.

In regards to the macroalbumin...the endocrinologist said that my mom does have some minor protein in the urine. It could be due to stress on the body (she just had liver transplant 7 months ago), it could be due to the loss in muscle mass that she has due to the cirrohis prior to liver transplant, or it could be due to being diabetic. The endocrinologist will rerun the urine test in January and if its still slightly elevated, she may start my mom on a beta blocker to protect her kidneys...if approved by the transplant team.

Both our TC and Endocrinologist both said there's no need to make an appointment with a nephrologist at this time. Possibly later down the road, but not now.

So glad we have a plan...makes me feel better.
Posted 12/11/2013 7:14 PM (GMT 0)
Thanks for the update!!!

Sandia
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