Elevated Creatinine levels on Sovaldi Treatment

[Shiraz20]

Hello guys,
New to the forum. I just need to ask that my father was on sovaldi treatment for 4 days when his (serum) creatinine level shot up to 2.53 which later came down to 1.96 and now at 1.43. He has no renal impairment and his kidney ultrasound and detailed urine report is perfectly normal. He is cirrhotic (Hep-c) at stage 2 according to doc (hep-c) which stopped the sovaldi + ribavirin treatment to save his kidneys. However during the period he was also on diuretics (furosemide) occasionally. His nephrologist says that it is safe to continue sovaldi treatment but the other doc gave a red flag (I have yet to have a dicussion with the nephrologist). So I am asking that is it possible that creatinine levels change because of sovldi or do i need to the change my doc? Also he has edema occasionally. He also has acid reflux.

[Shiraz20]

like i said he dropped to 1.43 as of 28th of month and it was the same on 18 of the same month.

[Shiraz20]

Stage B cirrhosis:
http://hepatitiscnewdrugresearch.com/staging-cirrhosis.html

[Shiraz20]

he has a eGFR of 90 which is normal i assume. Also he was on protien pump inhibitors and has moderate anemia with 7.6 haemoglobin and nearly 50 platelets (havent checked the units for these). He is genotype 3 but there is something that i read in the copy of sovaldi.
'No dose adjustment of SOVALDI is required for patients with mild or moderate renal impairment.'
I also read that in ~2% patients creatine kinase elevated to about 10 percent of the normal value. Dont know what realation does creatine kinase have with creatinine. Anyone please elaborate.

[SurfsideGal]

Good catch, Hrsepwrguy. I should have read more closely.

[hrsepwrguy]

If he is anything other than genotype 1 (being pakistan and the fact he is on only sovaldi and riba, I'm guessing he is not geno 1) Viekira Pak will not work for him, I hope you can find a solution that will work for him

Have a great day

[SurfsideGal]

I would ask your dad's doctor if perhaps Viekira Pak would be a better choice of treatments for him. I wish him the best.

[CoWriter]

If your dad has cirrhosis then he has stage 4 not stage 2.

A GFR (Glomerular Filtration Rate) is the best test to assess kidney function. If his GFR is lower than 60 that would put him at higher risk of developing renal failure during treatment with Sovaldi (or Harvoni).

Some people may have mild renal impairment and not be aware of it and the fact that he gets swelling would alert me to watch kidney function.  Plus the fact that he has cirrhosis.

Two people in our group developed renal failure during treatment with Sovaldi/Olysio.  Both had cirrhosis.  One started with a GFR of 60, cleared the virus but ended up on dialysis permanently.

What I'm trying to say is that people with cirrhosis seem to be at more risk and your father developed problems after only 4 days and his creatinine result is still high. Plus, I doubt that you can resume Sovaldi after stopping several days..because stopping might cause you to become resistant to the Sovaldi.

I'm sorry it's not the answer you wanted to hear.

Co

[patra_]

did your Dad increase his water intake as we all stress?

I would ask his Dr if the combo of no, or minimal, water, diauretic, and the Sovaldi was the culprit?  Especially since there was no abnormality showing when his nephrologist followed up.  

Second, did he drop back into the norml range when taken off the Sol?

I AM NOT A DOCTOR as hepcandme stated, but when I saw that he was on a diuretic and Sovldi, my mind immediately jumped to the question: was this completely dehydrating him?  I surely would ask his Dr about this.

I had not experience with that problem on Sol/Riba for 24 weeks, but I am/was not on diuretics at all, AND I drank 120 a 140 oz water daily.

Just a thought.

Good luck to y'all.

[Shiraz20]

Thanks anyway.

[hepcandme]

I know

I realize this was far beyond my knowledge level as, compared to your father, mine are just slightly off

I really wish I could be more help...

[Shiraz20]

Your levels are quite low as compared to the lab report. The report says it normals on 0.7 to 1.2. The units are: mg/dL

[hepcandme]

Lemme go look. It's not one that I usually  focus on. Oh wow, I see now that your dad's levels are really high and I'm sorry that I don't know what that means exactly

Here's my results from the last few months:

0.74 0.68 0.71 0.76 0.70 0.67 0.68 0.68 0.67 0.61

I did find this:

http://www.medicinenet.com/creatinine_blood_test/article.htm

I can see that elevated creatinine levels can be quite dangerous so, since you have several docs giving you different opinions, get a third or a 4th is all that I can advise

I'm sorry that he had to stop treatment but I am also hoping that he can get that under control and get back to treating

Good luck to you and keep us posted!

[Shiraz20]

And i forgot to mention, his doc stopped the treatment for more than a week now.

[Shiraz20]

Thank you.
But could you tell how much of an elevation did you observe?

[hepcandme]

hmm

my creatinine level went up as well on the first labs but then leveled off in a few weeks. I also take a small dose of diuretic ( 25 mg of Spironolactone) before and during treatment and probably forever

Honestly, we are not doctors here but yours is an excellent question and I am interested in what others have to say about their experiences

And, if your dad can cure his Hep C, it's got to get better from there!