Anti-viral meds?

[Jewels]

Hello all - Good news and bad news...my 2 year lab results were much better than at 1 year.  Creatinine at 1.0 and GFR up to 59 (was at 47) and all other labs are normal.  Bad news is I have shingles, and it is pretty miserable.  I am wondering if anyone has any information on the anti-viral drugs they often prescribe (acyclovir, famciclovir, or valacyclovir.)  I read that they are eliminated through the kidney, so that makes me a little nervous.  When I was at the doctor 2 days ago the rash was mild so we agreed that it didn't make sense with the meds (so I didn't ask a lot of questions about it) but now it has gotten worse and I am looking for ways to relieve or shorten the life span of the virus.

The other thing that has been suggested is 2000mg/day of Vit C and L-lysine but I have heard too much vitamin c can cause kidney stones and lysine is eliminated through the kidney and can cause gall stones. 

I always thought shingles was an older persons virus...not so!  Anyone who has had chickenpox can get it (1 in 3 do.)

Thanks in advance if you can share any knowledge!
Julie

[Clark]

I'm surprised your PCP didn't recommend the vaccine and acyclovir immediately, as early intervention is supposed to significantly reduce the intensity of an episode and reduce the likelihood and frequency of future episodes. On the anti-virals, like just about anything for us now, make sure your PCP maintains focus on your renal clearance numbers for dosage and followup to ensure you're not experiencing toxic buildup due to lack of clearance. Best wishes.

[sherri]

Jewels,

Sorry to hear about the shingles. I have never had it but have heard it is quite painful.

Whether to take medication that is excreted through the kidney is always a dilemma living kidney donors will face, especially as we age. This is something I thought about a lot before agreeing to donate, as I never felt one of my kidneys was a spare. Our lone kidney generally picks up the slack to about 75% (depending on age) after we donate half of our nephrons (the working units of the filtering system of the kidneys). However, what happens when we really need 100%? As we age, everyone's kidney function deteriorates so it is not only kidney donors who need to watch kidney function. We all should be aware of nephrotoxic dyes and medications.The best you can do is consult with a knowledgeable nephrologist who is aware of your kidney function to see what would be the risk of not treating to potentially protect the kidney versus treating and possibly overtaxing the kidney. Sounds like your GFR has bounced back with a creatinine of 1. There may also be ways to protect the kidney while taking certain medications that go through the kidney, like extra hydration and more frequent blood and urine labs to see how the kidney is compensating. Hopefully the specialist can help guide your PCP to get the safest results for you.

Let us know how it works out for you and hope you feel better soon.


Sherri

[Fr Pat]

     I hope you will get good treatment, but I don't really know anything about those meds.
     But I did want to add for the benefit of other readers that a vaccine is available to help PREVENT shingles and I got it last year. (I donated a kidney 12 years ago.) We are in danger of getting shingles not only if we have HAD chicken-pox, but also if we were ever EXPOSED to chicken pox. I never had chicken pox, but the blood test indicated that I had been exposed to it, so they gave me the vaccine.
    best wishes,
    Fr. Pat

[donor99]

I donated 15years ago got shingles last year( Im an old fart)
...Valcyte worked great...no harm to my kidney...creatinine is 1. They give it to kidney recipients...should not hurt your remaining kidney

[Jewels]

Thanks for the responses and suggestions.  I checked back with my PCP, who consulted with a nephrologist, and they prescribed famciclovir.  I asked the pharmacist and I called the transplant center and consulted with a nephrologist and all agreed it is safe to take as long as I take it with a lot of water, and only for a week.

I am hoping it provides some relief and shortens the duration.  This discomfort is pretty close to having a kidney removed!

Thanks,
Julie

[leah.faith]

I take aciclovir every couple of months for , um, ehem, well, you can guess I'm sure. Of course every single doctor I talked to before donation knew this and it is currently not on the list of medications that are known to cause kidney damage. I was told to take it regularly when needed.
FYI, L-lysine is ok and works better than nothing, but aciclovir is by far more effective, by a long long long shot.

Fun Fact:  NSAIDS is linked to kidney damage because they cause the blood vessel leading to the kidney to restrict which means the kidney receives less blood.