HepC, TX and Kidney Disease

[slagle2]

Later this week I have an appointment with a doctor who treats Hep C and who is part of a group that has been running various clinical trials on HepC drugs.  I'm getting my questions together as I want to be prepared for the office visit and I have concerns with regards to HepC TX and kidney disease.  

I am Genotype 1a and had TX (pegalyated interferon and ribavirin) ten years ago but relapsed after a viral breakthrough at 6 months.  A needle biopsy nearly three years ago showed Stage 1 fibrosis and Grade 2 inflammation which is about the same as a needle biopsy I had over ten years ago.   A FibroSURE test of about a year ago showed F0 or "no fibrosis" and A0 or "no activity". An abdominal CT scan at that time showed "scattered calcified granuloma" in the liver.  I had a viral load of about 5 million.

I was diagnosed with kidney disease 18 years ago which was the same time that I learned I was infected with HepC.  Two or three years ago my Glomerular Filtration Rate (GFR) was above 60 which is Stage 2 kidney disease and now it runs in the 55-70 GFR range which is Stage 2-3 Kidney disease.  I don't seem to make urine as quickly as I once did and I'm concerned that my kidneys may not be able to expel the excess ribavirin and interferon from the standard TX.  I see a nephrologist twice or more a year and he says my kidneys should be able to handle the drugs.  He says that the ribavirin is worse on the kidney than the interferon.  The HepC might be the cause of my kidney disease but unfortunately about 35 years ago I was an extremely heavy stimulant abuser and of course that can damage the kidney also.  

I'm hoping that somehow I can hold out till the new drugs are available.  I will probably have a needle biopsy done to check the progression of my liver disease and if possible just wait for the newer drugs such as Solvad and Olysio or Slovad and Ledipasvir as they would probably be easier on the kidney.  

Some years ago I heard an interesting interview on the Larry King show about HepC, kidney disease and drugs.  Larry was interviewing Natalie Cole, the singer and daughter of Nat King Cole.  Natalie had been treated  with interferon and ribavirin for her HepC and had apparently been cured.  But after the treatment and she believed because of the TX she went into kidney failure and had to go on dialysis.  At the time she had been on dialysis for nearly two years and was still touring the world singing.  The interview was largely about that, how a woman on dialysis could make global singing tours.  She was adamant that the TX had caused her kidney failure.  

BUT, in listening to the interview I believe I discovered the more likely cause of her kidney disease.  She had been for many year extremely addicted to cocaine and the way she described it she had consumed literally millions of dollars worth of the drug as she had the resources from her performing career to pay for it.

I would appreciate any thoughts or guidance anyone might have.  

[slagle2]

Yesterday I had my appointment which was not with the doctor but with the PA who is in charge of the HepC program and their HepC clinical trials.  She is very good and scheduled a bunch of blood work including a HCV viral load test.  She also scheduled a Fibroscan or my liver which she says is in some ways better than a needle biopsy.  So in about a month I have another appointment, this time with the head doctor.  

She says they no longer use Victrelis or Telaaprevir to threat HepC but have moved on to the newer drugs.  Next visit I should know their program for me.  She doesn't seem too concerned about my kidneys at the present.

[Verdugo]

I can only offer you an opinion as I'm in a similar boat.  By that I mean, I appear to have very little liver damage or inflammation but the disease appears to be damaging other systems in my body. I've had this disease for 40+ years.  At a routine blood test last year, my a1c test came in at 5.7, making me "pre-diabetic".  I didn't see that coming!  My hormone, cholesterol, and hemoglobin levels were all abnormal.  The doctor that I am seeing now believes there's a connection between all of these results and my HCV.  My new belief is that something's got to give -- if not your liver than some other system.

Please let us know how it goes with your doctor.  

Cheers, V.

[slagle2]

Thanks for your reply, You don't hear much said about HepC and kidney disease but I know that there is some association, I have had doctors say as much but none of them have anything definite to say about it.  I was wondering what might be the treatment history of others with reduced kidney function.  Did TX make the kidney problems worse and if so did they improve at the end of TX?  

I will surely ask my doctor, who has had very extensive extensive experience treating HepC what he thinks about it when I go for my appointment tomorrow and will report back here what he says.  

[dontworry_behappy1]

People on this forum aren't doctors.   You have an appointment scheduled this week to go over your concerns.    It's your doctor who is going to know if your kidney condition will be an issue with treatment.   It sounds like you have talked to a doctor who says that your kidneys can handle the treatment.  It sounds like your Hepatitis C is in a place where you can wait for better treatment.   This would be what I would be discussing with your doctor this week.  

Best to you