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Discussion:
creatinine increase with pain meds
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My creatinine stayed level at 1.1 for over 3 1/2 years and after eight months of pain meds it has gone up to 1.3

I wonder if this is related to the pain meds having to filter through the kidneys? curious if this happens to others.
Posted on 02/09/12, 03:30 am
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Reply #1 - 02/09/12  5:36am
" I don't know, but I'm guessing that you've been taking pain meds because of increased pain levels, which may stem from having more/larger cysts. The increasing/ growing cysts then lead to a decline in kidney function ultimately. The link is there, but it's not causative.

Chewitt "
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Reply #2 - 02/09/12  7:21am
" creatinine fluctuates due to several factors, including dehydration. small increases should not normally be of concern from one reading.
it is important to stay well hydrated, even more so while on medications. "
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Reply #3 - 02/10/12  6:50pm
" An increase in creatinine after prolonged useage of pain meds makes some sense to me.

Some pain meds certainly can cause you to retain sodium and/or water, which may alter your hydration levels and consumption of water without you realizing it. They can also elevate blood pressure, reduce inflammation, influence heart rate, and much more.

To put it in simple terms; pain meds really affect your body and diseased kidneys are going to be more sensitive to that fact.

I'd recommend discussing it with your doctor as I could be completely wrong. If I'm not, perhaps he or she could help you find another way to alleviate your pain or another way to manage it. "
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Reply #4 - 02/22/12  11:15pm
" You are still in pretty good shape at 1.3, i am at 1.6 after a transplant. "
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Reply #5 - 02/23/12  6:33pm
" Jenny,
I've been on some very heavy duty pain medication for nearly 5 years and it hasn't affected my creatinine at all. In fact in those 5 years, my creatinine has only gone up 0.4 mg/dL, which is most frustrating considering my kidney function is the driving factor for the combined liver/kidney transplant I need (my GFR is now 28 and the kidney team won't consider the kidney transplant till I hit 25 or lower and my kidneys just don't want to fail; the pain medication is for the ridiculously large polycystic liver that is bent on world domination, one person at a time!).

FYI, the pain meds may cause you to have a dry mouth, so be sure to keep up with your fluid intake and if that isn't enough (it works for me as I sip on water throughout the day; I can't drink more than a few ounces of anything due to the compression of my stomach (wherever it is) by my liver), talk with your dentist and nephrologist about using a mouthwash that will help keep your mouth mouisturized so you can avoid the urge to suck on hard candies, even the sugar-free varieties. Your body and your teeth will thank you. And remember, your dentist is just as important a member of your medical team as everyone else is, so keep him/her in the loop and get those regular checkups and cleanings. If your dental insurance has the option (read the plan carefully), you may be able to get the dentist to write that you need cleanings/check-ups (not x-rays) three times a year, instead of the usual twice a year at no additional cost (my dentist/insurance are doing this for me). Kidney patients are prone to dental problems, as are transplant patients and those who need pain medication for an extended period of time (more than the usual 10-15 days post surgery, etc.), so do what you can to keep to maintain your oral health. The last thing any of us need is dental problems on top of all the rest of the fun this disease brings with it!

Best wishes,
Ruth

PS Creatinine fluctuates with time of day (lowest around 7 am/highest around 7 pm; what you've been eating; your hydration status; what standard the lab is using for calculating/calibrating serum creatinine (a new universal standard went into effect over a year ago, but not all labs are using it, some are still converting their machinery...the new system reports creatine with 2 digits after the decimal point, not just one), or any number of other factors. At 1.3 you're still doing great; it's not a signficant increase from 1.1 although it feels it after you're used to the same number for 3.5 years (which is unusual; most people get some variation in 3+ years). :) "
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Reply #6 - 02/23/12  10:07pm
" Thanks for all the replies. I am very thankful my numbers aren't moving much the last several years. Now if i can just get this pain managed it would be much better. I'm starting to think this might just be something I have to learn to live with. "
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Reply #7 - 02/23/12  10:31pm
" Ruth,they are not willing to budge at all for the transplant early? Would they be willing to do a dual live donor transplant? Or is this possible? "
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Reply #8 - 02/24/12  4:12am
" My neph tells me that at this stage of kidney failure, I too am at 27% that I can no longer take advil for migraine headaches. I find it a real loss since it used to work so well for me.

I don't get much relief at all from oxycodone. I think that if I were in a position to where I was waiting for my kidney function to drop so that I could get a dual transplant I would be awfully tempted to start taking advil in addition to my regular painkillers. Not in over the top doses of course.

Because really it works well and is not something that would be of concern other than affecting kidney function. I sure wish I could find a good replacement for migraine relief. "
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Reply #9 - 02/27/12  2:46pm
" Jenny,
The challenge is I need the dual liver/kidney transplant, but I'm not in liver failure (it's a quality of life issue) and my kidneys just don't want to fail (which is a good thing for most people and I'm not arguing because I'm not exactly looking forward to a transplant). And there are so many people who need livers and kidneys more than I do (not dying from liver failure and not on dialysis). It's just a Catch-22 situation. I'm still in touch with the transplant program as is my nephrologist on a regular basis; we're just waiting till I hit their magic number! Right now I'm just not in any rush; the whole idea is petrifying!

At least I have good doctors locally and a very good pain management plan (I had a horrible reaction to the new version of OxyContin when it was released over a year ago (my body couldn't absorb it at all and it somehow blocked all of my breakthough pain medication as well). As a result I was switched to methadone which works very well (I don't get sedated by much of anything) and my GI tract is very, very happy (for some reason the methadone along with Colace has my system purring along, which is amazing considering how compressed and convulted my GI tract is. I still use oxycontin immediate release for regular breakthrough pain and have hydromorphone (dilaudid) for severe breakthrough pain and that combination has kept me out of the hospital due to a pain crisis for 3 years (which is amazing).

When my pain is severe, my creatinie does go up (e.g when I've been in the ER, my creatinie has spiked, as does my glucose, the latter being a normal response to pain and the body's fight or flight system). But it always goes back down to "normal" once the pain is back under control. And I know when I've been sick (e.g. when I had a kidney infection back in 1993) my creatinine spiked (it was normally 1.0 then and went up to 1.7, but I also had a kidney stone that was intermittently blocking the urine from leaving the kidney (it was a 3 cm stone, way to big to go anywhere!).

When you look at your labs over the period of time that you've been on the pain meds, have there been changes in your BUN as well? That will give you an idea of your hydration status. I'm almost always dehydrated so I was suprised when my last BUN was only 17 (my "normal" is 24, but I worked hard on getting and staying hydrated in anticipation for the labs). It's amazing what water will do for you! It also helps reduce the constipating side effects of the pain medication (a nice bonus).

I wish you well and hope your pain is under control. If not or the cost/co-pay is ridiculous, talk with your doctor about methadone (it's only available by generic). It only costs pennies a tablet (versus the dollar(s) per tablet for the other long-acting pain medications; in fact a full month of methadone may cost less than your co-pay!). And if you can get past or are not affected by the sedative affect, it works very well and, at least for me, is easier on the GI tract.

Kelly,
I take Fioricet for my migraines (a combination of Tyelenol (325 mg), butalbital (a mild barbituate, 40 or 50 mg) and caffeine (50 mg). It's the only medication that's ever helped my migraines. None of the traditional migraine abortives ever worked to stop a migraine cold in it's track and the adverse effects (chest pains and shortness of breath) from triptans and ergots were too severe for me to try all the different types. So Fioricet is my "pain" medication for migraines.

To prevent them I take topirimate (Topamax) twice a day (100 mg split dose) and that works amazingly well to reduce the frequency and severity of my migraines (I had tried Botox but I didn't like the numb feeling and it was hard to get the regular appointments as the trained doctors were constantly being deployed so instead of every 90 days I was getting them every 120-180 days, which makes it less effective...but those did help as well). I still get migraines (I can't control Mother Nature; alas barometric changes are my major trigger), but they are no longer multi-day migraines that knock me out for days on end. Now they're controllable with Fioricet and generally only out for a few hours instead of days (I used to lose up to 2-4 days of work 2-3 weeks a month; I'd be able to work a few hours in the morning and then need to leave in time to take the Fioricet as I was pulling into my driveway; otherwise my husband would have to come get me as I would be lying in an old office in the dark with earplugs and an eyemask on. The Topamax make a huge difference in reducing my headaches and didn't affect my kidney function (which I was concerned about, but no change at all).

Best wishes to both of you!
Ruth "

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