Question about bacterial and viral infections in ESRF.

[kristina]

Has anyone ever been diagnosed with a bacterial or viral infection whilst in ESRF
and were they given any medical advice or treatment for it?

Did their Creatinine and Urea (Bun) levels rise,
and did the Creatinine and Urea (Bun) levels reverse and become better again
when the bacterial or viral infection was gone?

There are many viral infections going around and I wonder how serious the damage might be
to the kidneys in ESRF if one caught a virus?

I also wondered how the treatment itself might influence the kidney function ?

Thanks from Kristina.

[obsidianom]

Most viruses dont directly attack or effect the kidneys. However their secondary effects can effect the kidneys. Symptoms such as fevers can cause dehydration which is dangerous on weakened kidneys. GI virsues causing diahrea and vomiting also can cause dangerous dehydration. The BUN and creatinine can be effected by dehydration . This can be reversible but not always if there is severe dydration and damage to the kidneys. The key is to not become dehydrated.
Bacteria are a different animal. Yes they can kill the kidneys and there is risk of bacteremia and heart damage. Urinary tract bacterial infections are particulaurly problematic if they infect the kidneys. They can kill the kidneys if untreated.  I have seen this occur. Dont play around with suspected UTIs.
 Kidney patients are more prone to bacterial infections due to reduced immunity and more bacteria in noses and skin. 
Botton line is prevention. Washing hands constantly and avoiding sick people if possible helps. Careful handling of dialysis lines/needles , disinfectiong the skin before cannulating etc. helps.
There is no sure way to stop infections but we do our best.

[cdwbrooklyn]

Good afternoon Kristina,
I’ve had a bacteria infection last year.   I went to the dentist and did not take any antibiotic and a few weeks later, I was getting chills and a sight fever while I was doing my treatment at home.  I told my nurse and she took some tests and found out I had a bacteria infection.  I had to go to the clinic four times a week for six weeks to get IV antibiotic.  It took one hour each time to give it to me by IV.   There were no side effects regarding by kidneys.  However, it was tiresome leaving work early and going to the clinic as my clinic is in another bought from where I live. 

[kristina]

Hello obsidianom and cdwbrooklyn,

Thank you very much indeed for you quick reply.
It is difficult to know if medications for bacterial/viral infections
might also have a detrimental effect on ESRF kidneys,
either in the short term or long term.
I know that people with a compromised immune system (autoimmune diseases)
Have a particular concern with this.

cdwblooklyn, could you please tell me the name and the dosage of the IV antibiotic you were given ?

Thanks again from Kristina.

[cdwbrooklyn]

Kristina, I'm waiting to hear from my nurse and I'll get back to you.

[kristina]

Thank you cdwblooklyn, that is very kind of you.

Kristina.

[obsidianom]

There is no real medication treatment for viruses.  Bacteria   require antibiotics, but the antibiotic has to match the sensitivity of the bacteria. It will be a different antibiotic for different bacteria. Generally antibiotics dont damage kidneys except for aminoglycosides like gentamycin. Sometimes floroquinolones like cipro and levaquin have side effects too. Most cephalosporins like cefazolin (kefzol) are safe for the kidneys and are the first line choice for bacteremia that is NOT MRSA.
Autoimmune disease is not really a compomised immune system. It is the immune system attacking the person . The immune system is actually over active. 
      Compromised immune systems occur with kidney disease and especially diabetes. In these cases the immune system is underactive.
If you have specific questions on these, please ask.

[kristina]

Thanks again obsidianom,

your information is again very much appreciated.

Thanks again from Kristina.

[MooseMom]

Sometimes floroquinolones like cipro and levaquin have side effects too.

I've had to take levaquin on two occasions because I am allergic to Bactrim.  Levaquin makes me nauseous by day 4 of a 7 day course.

The levaquin was prescribed by my neph, so I felt safe taking it as far as my renal function is concerned, but I've listed it as a drug to be avoided if at all possible.

But obsidianom is right in saying that an autoimmune disease is not a "compromised" immune system.  I have fsgs which is thought to be an autoimmune disease (no one seem to know for sure), but the drugs I take to protect my new kidney from rejection cause my immune system to be "compromised" and/or "underactive".  So maybe now my immune system is now normal!   

[kristina]

Hello MooseMum,

Thanks for the information.

I do hope things work out well for you.

Kind regards from Kristina.

[MooseMom]

And you, too, Kristina.   

I've not noticed any decline in renal function during any times I've been treated for infections, although I don't remember having any viral infections other than colds.  I hope you are not having to deal with this issue!

[kristina]

Thanks again, MooseMum

I also hope I won't have to deal with this issue,
because I suffer from all sorts of allergies (especially Penicillin) and I also suffer from a severe drug-intolerance.

Thanks again from Kristina.

[Ninanna]

I had the flu (confirmed with nasal swab) in January of 2012. I ended up going to the emergency room because I felt so bad and I was afraid that it would push my 17% gfr to a point where I would need dialysis. My kidney function did drop to around 10% and I did end up being admitted to the hospital for 2 nights as a cautionary measure. I was treated with IV fluids and an anti-viral. This episode also caused me to have to start taking phosphate binders. They also with held my lisinopril while I was sick. I'm a little fuzzy on the reasoning for it but it had something to do with actually hurting the kidney while I was sick. My gfr did recover. My kidney function has continued to slowly decline, but that was the way it was heading before I got the flu anyways.

[kristina]

Thank you, Ninanna for the information.

I am so sorry for what you went through
and I do hope your kidneys still function for a long whille without dialysis.

Best wishes from Kristina.

[obsidianom]

I had the flu (confirmed with nasal swab) in January of 2012. I ended up going to the emergency room because I felt so bad and I was afraid that it would push my 17% gfr to a point where I would need dialysis. My kidney function did drop to around 10% and I did end up being admitted to the hospital for 2 nights as a cautionary measure. I was treated with IV fluids and an anti-viral. This episode also caused me to have to start taking phosphate binders. They also with held my lisinopril while I was sick. I'm a little fuzzy on the reasoning for it but it had something to do with actually hurting the kidney while I was sick. My gfr did recover. My kidney function has continued to slowly decline, but that was the way it was heading before I got the flu anyways.

ACE inhibitors like Lisinopril are funny drugs in terms of kidneys. They are somewhat renal protective by lowering angiotensin effects and so lower blood pressure. However they can at times reduce renal blood perfusion which can damage kidneys. In general they are very good meds. There are times when pulling them is also safer, like when you are dehydrated.

[Ninanna]

Ah, thanks Obsidianom for the info!

[cdwbrooklyn]

There is no real medication treatment for viruses.  Bacteria   require antibiotics, but the antibiotic has to match the sensitivity of the bacteria. It will be a different antibiotic for different bacteria. Generally antibiotics dont damage kidneys except for aminoglycosides like gentamycin. Sometimes floroquinolones like cipro and levaquin have side effects too. Most cephalosporins like cefazolin (kefzol) are safe for the kidneys and are the first line choice for bacteremia that is NOT MRSA.
Autoimmune disease is not really a compomised immune system. It is the immune system attacking the person . The immune system is actually over active. 
      Compromised immune systems occur with kidney disease and especially diabetes. In these cases the immune system is underactive.
If you have specific questions on these, please ask.

Kristine, my nurse basically said the same as obsidianom said.  I had bacteria in the blood based on my culture test, which determined what antibiotics I had to take.  It was really serious because I has to go 4 times a week for 6 weeks. 

[kristina]

Thank you obsidianom,

When I was diagnosed with ESRF in August 2006 I was told I had to be on dialysis within 6 months
and I was prescribed to take “Lisinopril” instead of my usual (since 1992) 5mg “Istin/Amlodipine” per day.
Unfortunately I reacted allergic to “Lisinopril” and felt very nauseous, dizzy and my BP went out of control.
So I had to go back to “Istin/Amlodipine” to regulate my BP and everything went back to normal again.
Fortunately my “two little fighters” are still with me functioning, but recently they have become a little upset
and hopefully they get back to their “normal” pre-dialysis 10-12% again.

Thank you CDWBrooklyn,

Sorry that you went through this terrible episode and hopefully it will never repeat.

Thanks again from Kristina.