Renal insufficiency stadium II

Question

Partly increased creatinin values in the blood (85/94/96/100), measurement of the glomerular filtration rate according to the MDRD formula (67ml/min/body surface on the 9th december 2013, on the 24th february 2014 - 62.7) at a control done by the general practitioner. These values fluctuate and were already at 54.
After this, a scintigraphy of the kideneys was done in September 2012.
Result: normal total clearance on the left side, right kidney with lighter functional impairment.
An appointment at a kidney specialist revealed: Result: chronic insufficiency of the kidneys stadium II, nephrosclerosis, chronic interstitial changes on both sides, sclerosis of the aorta. The physician said, that the result does not upset, as the scinitgraphy would be all right. Follow-up visit in one year.
I am a CF Patient (over 45 years of age) and take azithromycin 250mg every second day over the whole year, I inhalte with colistin, rh-DNAse. In case of acute infections i.v., as at the moment.
Now I am a bit worried, as very different statements exist. However, one cannot disrupt anything of the therapies. Coud probably azithromycin change the creatinin values this way? Can one do anything about it, in order that these values are not going to worsen?
Many thanks,
S.

Answer

Hello,
you should discuss this with your doctor of your CF center. In case of an impaired kidney function, one should, if possible, leave out all drugs, that may influence the kidney function - I would include azithromycin in this group. It is not injuring for the kidneys, however nearly all drugs have to be excreted via the kidneys. Therefore one has to weigh the advantage for CF against the disadvantage for the kidneys, and this should be done by somebody, who knows you and your course of CF well.
Also in case of i.v. antibiotic treatments one has to pay attention to avoid harmful drugs for the kindey and, if necessary, to adapt those to the kindney function.
The control at the kidney specialist should be done additionally at least once a year, unfortunately one cannot improve the kidney function but one can try, by taking the above mentioned into account, that the kindney function does not decrease furhter.
Best regards,
Prof. Dr. Joachim Bargon

30.06.2014