cyclosporine

[mel/pat]

My husband has been told he will need to go on dialysis but they say it may be a good idea to try cyclosporine first to see if they can delay the start of dialysis by 1 or 2 years. Cyclosporine is an immunosupressant and we are concerned the this will cause him to become fragile and ill and less able to tolerate dialysis when it is time to start. Does anyone have any experience with cyclosporine? They are not sure it will do any good. He is 79 years old.

[Beth Witten MSW ACSW]

What kind of kidney condition does your husband have? What kind of doctor is recommending using cyclosporine to treat his kidney condition? If he's not seeing a kidney specialist (nephrologist), I suggest that he get an appointment right away.

What percent of normal kidney function does he have now? You can find out by asking the doctor his glomerular filtration rate (GFR) or creatinine clearance. The number he/she tells you is the approximate percent of kidney function he has left. If you have lab test results, you can use an online calculator to calculate his GFR. One can be found at:
http://www.kidney.org/professionals/KDOQI/gfr.cfm

Cyclosporine is most commonly used in patients with transplants to prevent the body from rejecting a transplated organ that the body sees as foreign. Cyclosporine can be toxic to kidneys and can cause kidney failure. When transplant patients take it, they need regular blood testing to be sure that kidney damage isn't occurring with its use. Immunosuppressants can cause some unpleasant side effects in addition to making it harder to fight off other diseases. Before agreeing to take cyclosporine, read this information:
http://www.nlm.nih.gov/medlineplus/d...di/202176.html

I'd ask the doctor if there are other drugs that could be taken instead to protect his kidney function. Be sure his doctor knows what other prescribed and over-the-counter drugs and herbs he is taking so he/she can tell whether any of them could be contributing to his kidney problem, such as non-steroidal anti-inflammatory drugs and certain Chinese herbs.

To protect kidneys and treat early kidney disease nephrologists usually recommend limiting protein in the diet, controling blood pressure and/or protein in urine through use of ACE inhibitors or ARBs (classes of blood pressure medicines), and only doing dye studies when absolutely necessary.

You might also want to read the information about kidney disease on Kidney School:
http://www.kidneyschool.org