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Bala
Member
Username: Balapandian
Post Number: 73
Registered: 08-2010
| | Posted on Monday, August 25, 2014 - 04:11 am: | 
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I'm 1.5 years post kidney transplant. My neph has reduced the dosage of tacro and steriod as I suffer from diabetes and UTI.
If a rejection should occur because of this reduction, how long will it take to show up in the creatinine? in just 10 days or longer?
If there is no change in creatinine for say 30 days after reduction, then the above reduction is fine and there won't be any rejection later on?
Those who have undergone reduction in medicine, pls share your experiences.
tacro reduced from 5mg to 4mg a day
steriod reduced from 10mg to 7.5mg a day
myfortic 360mg twice a day ( no change)
Apr 2013 Kidney Transplant
Jun 2012 Both kidneys removed
Polycystic Kidney Disease
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Cora
Member
Username: Cora
Post Number: 565
Registered: 06-2007
| | Posted on Monday, August 25, 2014 - 05:45 am: |
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Hi Bala. Obviously, I'm not a doc, but those reductions in meds could just have easily been done due to the fact that you are past the "danger" period of first year rejection. It's a minimal change.
To give you an example, I came down with CMV (long story, not likely for you at this point) and they stopped my cellcept entirely for over a month, and my other drugs were cut in half. This went on for month. Nothing changed.
Typically rejection doesn't happen that fast, and due to the lower dose, I'm sure you'll be getting labs often enough. Acute rejection can be discovered easily enough and treated.
Best of luck and keep us posted. At this point for you (I'mm almost 12 years post kidney transplant) you will still be nervous about dose changes. Trust me, yoiu get used to it. It happens all the time.
Dx with T1 in 1966
Kidney tx in Minneapolis 2002
Pancreas tx in 2008 |
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bill s
Member
Username: Bill_s
Post Number: 163
Registered: 08-2011
| | Posted on Tuesday, August 26, 2014 - 01:07 am: |
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I'm 3 yrs post TX and depending on your transplant team your tacrolimus may be reduced to about 2mgs/day (it's controlled by your monthly blood tests) and your prednisone to 5mgs/day and possibly eliminated if your health is good (my team just eliminated my pred dose this week). UTIs should not be a major concern as my nephrologist says all his TX patients average about 2 UTIs/year. If you're having too many, get your team to get you a cystoscopy (exam of the bladder, it's relatively painless and will ease your concerns - I just had one and my bladder system is in good shape). I've switched from tacrolimus to Zortress 2 months ago and I can't detect any difference in how I feel. I don't have your diabetes problem and so don't know what effect that has on the kidney. Keep in touch with your TX team and hope you continue to do well. |
Bala
Member
Username: Balapandian
Post Number: 74
Registered: 08-2010
| | Posted on Tuesday, August 26, 2014 - 09:13 am: |
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thanks cora for your reply. I'm testing creatinine every 10 days. I have been suffering from a mysterious kidney infection since my kidney transplant. The tacro dosage was reduced mainly because of my kidney infection and also diabetes, but no help. Initially the infection was detectable in urine culture(positive) with E-coli. I have been on nitrofurantoin(antibiotics) for this infection for the past 13 months. I was on Imuran earlier with some liver issues (increased ALT and AST). So, neph swithced to Myfortic in June, this is when the kidney infection increased in spite of taking nitrofurantoin, but the urine culture is always -ve for the past several times. Myfortic is usually reduced in case of CMV attack, so why not do the same thing for kidney infection?
Apr 2013 Kidney Transplant
Jun 2012 Both kidneys removed
Polycystic Kidney Disease
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Cora
Member
Username: Cora
Post Number: 566
Registered: 06-2007
| | Posted on Tuesday, August 26, 2014 - 09:23 am: |
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Bala, early on I actually had a yeast infection in my new kidney. Have you been checked for this? You would need an antifungal, not an antibiotic if that is the problem.
And the myfortic is cut back with cmv because the combo (it's very weird) can drop you white count to near zero. Not good. With a kidney infection, your white count is liable to go up, and cutting the myfortic would make that worse. That's my take, anyway.
Dx with T1 in 1966
Kidney tx in Minneapolis 2002
Pancreas tx in 2008 |
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Bala
Member
Username: Balapandian
Post Number: 75
Registered: 08-2010
| | Posted on Wednesday, August 27, 2014 - 12:33 am: |
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cora, yes the urine fungus culture came negative, is this the test for yeast infection?
Apr 2013 Kidney Transplant
Jun 2012 Both kidneys removed
Polycystic Kidney Disease
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