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Author Topic: Cinacalcet and potassium levels?  (Read 970 times)
kristina
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« on: July 07, 2018, 05:42:15 AM »

Hello,
I am just wondering, how taking “Cinacalcet,” (Parathyroid problem) which slowly lowers the Alkaline Phosphatise level, creates potassium levels to rise up to dangerous levels?
Just wondered if this makes any sense to anyone. If it does, has anyone any thoughts on it. Seems a bit complicated.
Many thanks from Kristina. :grouphug;

 
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  He was completion and fulfillment in itself, like a meteor which follows its own path.
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Charlie B53
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« Reply #1 on: July 07, 2018, 07:07:06 AM »


I've been taking this for a long time.  Steadily been increasing long ago until reaching my current level of 90 MG nightly well over a year ago.

The only time my labs show any rise in potassium is if I change my diet somewhat, eating something I maybe shouldn't have.

But I often consider myself to be one of the 'Lucky' ones.
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kickingandscreaming
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« Reply #2 on: July 07, 2018, 11:21:26 AM »

Potassium is weird and a killer (in excess).  My answer has nothing to do with cinecalcet, but about drugs that can provoke the rise of Potassium.  Several weeks ago I was having breathing issues.  It started small and ended up really big with not being able to breath at all.  I had to call 911 and was hospitalized.  I couldn't breathe and my heart was going nuts.  I was terrified.  Since I also have asthma, I immediately attributed my issues to that.  But ones in the ER, they did blood work and found that my heart was in Atrial Flutter and that my Potassim was at 7.7!!!  Enough to kill me.  They got my Potassium down (with meds and with PD).  After I was released, I saw my nephrologist and she came up with a good explanation of why it happened.

I had been on 2 days of a 6 day taper course of Prednisone (60mg/day).  I was on the Pred to "break" the inflammation pattern in my asthmatic lungs.  But what it also did was send my blood sugar way up.  Turns out that high blood glucose pulls Potassium from the cells into the blood and this made my Potassium level shoot up.  On PD, I shouldn't have any issues with high Potassium as PD really washes out Potassium.  But I had missed a day of PD and the combination of all these factors nearly killed me

In regard to cinecalcet, I took it for about a week.  And felt awful.  I felt physiologically depressed and was anorexic.  That was the end of me taking that med.

s
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Diagnosed with Stage 2 ESRD 2009
Pneumonia 11/15
Began Hemo 11/15 @6%
Began PD 1/16 (manual)
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kristina
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« Reply #3 on: July 08, 2018, 02:46:38 AM »

Hello Charlie and K&S and many thanks for your kind replies, I very much appreciate your kind sharing of experiences.
Charlie, there is no doubt that you are very lucky and hopefully it continues like that and I send you lots of good-luck-wishes!
K&S, it is interesting what you mention about medical drugs provoking the rise of potassium (I wonder what sort of medication they are?) and I am sorry about your problems with asthma and I know how terrifying asthma can be at times.
But your potassium level of 7.7 must also have been a very shocking and frightening experience!!
I wonder what sort of medication the medics gave you to lower the potassium of 7.7 ?
... Next time I have a chance to see the doctor/neph I have to ask about my blood sugar, just in case.
Many thanks again for your kind replies, Charlie and K&S, it gives me a bit of an idea what questions to ask when I see the medics again.
The strange "thing" about the rise of my potassium-level is the fact, that it was already higher than normal at the last blood test and as a result I refrained for over a month from all the "goodies" which could possibly raise my potassium, but unfortunately to no avail, because the last blood test showed that my potassium had risen even further...   ???
Many thanks again from Kristina. :grouphug;
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cassandra
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« Reply #4 on: July 08, 2018, 03:35:13 AM »

Hi Kristina Cinecalcet lowers you Phosphate not Alkaline phosphate. Some BP meds increase Potassium, did anything change there? Also look at your dialysate, and to lower K+ they might use Calcium Resonium (the powder with water that you 'drink' like mud, or some infusion with some insulin dextrose mixture which 'pushes' K+ back into tissues (or something)


Love, Cas





« Last Edit: July 08, 2018, 01:16:39 PM by cassandra » Logged

I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
kristina
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« Reply #5 on: July 08, 2018, 08:14:39 AM »

Many thanks again Cassandra ! I shall ask the nurses about the dialysate and all the other questions I have learned here to ask about the rise in my potassium-level. Isn't life strange sometimes? There I am patiently waiting on the transplant-waiting-list and then something unexpected like that comes along... ::)
Many thanks again from Kristina. :grouphug;
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
                                        -   Robert Schumann  -

                                          ...  Oportet Vivere ...
cassandra
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« Reply #6 on: July 08, 2018, 01:22:45 PM »

O o sorry Kristina,


I should not answer questions when there is still Morphine in my system.


Cinacalcet lowers Para Thyroid hormone, not phosphates. Renagel/Sevelamer lowers phosphates. I have yet to discover what lowers Alkaline Phosphate. Mine stops rising when I increase Sodium Bicarb.
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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
kristina
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« Reply #7 on: July 08, 2018, 03:39:20 PM »

O o sorry Kristina,


I should not answer questions when there is still Morphine in my system.


Cinacalcet lowers Para Thyroid hormone, not phosphates. Renagel/Sevelamer lowers phosphates. I have yet to discover what lowers Alkaline Phosphate. Mine stops rising when I increase Sodium Bicarb.

Hello Cassandra, many thanks again and I do hope you feel better soon as well.
Thanks again from Kristina. :grouphug;
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
                                        -   Robert Schumann  -

                                          ...  Oportet Vivere ...
MooseMom
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« Reply #8 on: July 08, 2018, 05:08:54 PM »

kristina, I had all kinds of problems with potassium even though I was really careful about my diet.  It's really weird how different ESRD patients have different problems.  As my renal function declined, my potassium became more and more difficult to control, and by the time I had my transplant, I was taking 12 sodium bicarb tablets a day!  It was a real pain because those tablets (actually, I think they were capsules) were huge.  Is sodium bicarb a possible solution for you?
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kickingandscreaming
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« Reply #9 on: July 09, 2018, 04:18:24 AM »

How would sodium bicarb affect Potassium? 
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kristina
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« Reply #10 on: July 09, 2018, 06:53:41 AM »

Hello MooseMom and K&S and many thanks for your inputs.
MooseMom, like yourself, I have been extremely careful about my diet and fortunately it has worked until the introduction of Cinacalcet and new medication to lower my BP and all of a sudden my Potassium has gone up ... According to the Internet, Cinacalcet can rise Potassium-levels in ESRF-people and the same can also be said about some BP-medications and there could be an explanation ...
Many thanks again for your kind inputs, it has helped to create some questions for the medics ...
K&S, unfortunately I also don't know about the effects of sodium bicarb and Potassium-levels and hopefully we can find the answer.
Many thanks again from Kristina. :grouphug;
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
                                        -   Robert Schumann  -

                                          ...  Oportet Vivere ...
MooseMom
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« Reply #11 on: July 09, 2018, 07:32:41 AM »

How would sodium bicarb affect Potassium?

This article explains it better than I can!  I swear you have to become a biochemist if you are a kidney patient!

https://www.livestrong.com/article/360929-sodium-bicarbonate-hyperkalemia/
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
KatieV
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« Reply #12 on: July 09, 2018, 09:45:37 AM »

According to the Internet, Cinacalcet can rise Potassium-levels in ESRF-people and the same can also be said about some BP-medications and there could be an explanation ...

Knew about some BP meds, but didn't know Cinacalcet could cause Potassium to rise too!  Thankfully it doesn't seem to affect me that way, as I am on 180 mg of Cinacalcet a day (max dose!).
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~~~~~~~~~~~~
March 2007 - Brother diagnosed with ESRD, started dialysis 3 days later
April 2007 - Myself and sister also diagnosed with Senior-Loken Syndrome (Juvenile Nephronophthisis and Retintis Pigmentosa)

Since then, I've tried PD three times unsuccessfully, done In-Center hemo, NxStage short daily, Nocturnal NxStage, and had two transplants.  Currently doing NxStage short daily while waiting for a third transplant.

Married Sept. 2011 to my wonderful husband, James, who jumped into NxStage training only 51 days after our wedding!
~~~~~~~~~~~~
kristina
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« Reply #13 on: July 09, 2018, 01:11:46 PM »

Many thanks for this interesting article, MooseMom, it is really appreciated... and you can say that again: if you are a kidney-patient, you have to become a biochemist and not only that, but you also have to learn as much as you can possibly learn in a short space of time about renal medicine, diet etc... and the whole action is just in an effort to survive ESRF as best as is possible for as long as is possible ...
Hello Katie, I wish you further good luck with the Cinacalcet ... and ... how can your body manage to take the maximum dosage of 180 mg a day??  I do hope that you won't have ever any problems with it, because if you do have, life can become extremely complicated ...
Many thanks again for your kind inputs again from Kristina. :grouphug;
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
                                        -   Robert Schumann  -

                                          ...  Oportet Vivere ...
heisanberg
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« Reply #14 on: July 11, 2018, 03:12:42 PM »

hello every one, the stuff in my experiance that is given in emergency hyperkalemia,,,higher potassium levels is called "medical Regime" its a combination of 3 components  insuline , dextrose 25% and i forget the 3rd one , its used to push potassium back in tissues while they prepare you for dialysis, to my knowledge Calcium resonium (K-exelate) that muddy powder is not effective in patients on dialysis, please correct me whee i am wrong ::)
Bp medicines like "LosartenPotassium " and vasodilators, like Captopril, enalapril, preindopril e.t.c elevates potassium levels.
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kristina
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« Reply #15 on: July 12, 2018, 04:04:58 AM »

hello every one, the stuff in my experiance that is given in emergency hyperkalemia,,,higher potassium levels is called "medical Regime" its a combination of 3 components  insuline , dextrose 25% and i forget the 3rd one , its used to push potassium back in tissues while they prepare you for dialysis, to my knowledge Calcium resonium (K-exelate) that muddy powder is not effective in patients on dialysis, please correct me whee i am wrong ::)
Bp medicines like "LosartenPotassium " and vasodilators, like Captopril, enalapril, preindopril e.t.c elevates potassium levels.

Hello heisanberg ... and ... may I ask you : is your avatar in honour of Nobel Price physicist Werner Karl Heisenberg (1901-76) ?
Many thanks for your kind explanation. "My" Cinacalcet has been downsized enormously and hopefully my potassium-levels come down soon as well.
Many thanks again and best wishes from Kristina.
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
                                        -   Robert Schumann  -

                                          ...  Oportet Vivere ...
cassandra
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« Reply #16 on: July 12, 2018, 05:11:55 AM »


hello every one, the stuff in my experiance that is given in emergency hyperkalemia,,,higher potassium levels is called "medical Regime" its a combination of 3 components  insuline , dextrose 25% and i forget the 3rd one , its used to push potassium back in tissues while they prepare you for dialysis, to my knowledge Calcium resonium (K-exelate) that muddy powder is not effective in patients on dialysis, please correct me whee i am wrong ::)
Bp medicines like "LosartenPotassium " and vasodilators, like Captopril, enalapril, preindopril e.t.c elevates potassium levels.


Hi HB the 3' component in "medical Regime" is Calcium.


Calcium Resonium does work in patients on D as it works in me (on D 20+ yrs) but it can cause a lot of probs
And Nice still prescribes https://bnf.nice.org.uk/drug/calcium-polystyrene-sulfonate.html



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I started out with nothing and I still have most of it left

1983 high proteinloss in urine, chemo, stroke,coma, dialysis
1984 double nephrectomy
1985 transplant from dad
1998 lost dads kidney, start PD
2003 peritineum burst, back to hemo
2012 start Nxstage home hemo
       still on waitinglist, still ok I think
kristina
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« Reply #17 on: July 12, 2018, 06:02:02 AM »

Many thanks Cassandra and I shall try my very best to study and understand all the provided details and the problems it can cause, which sound quite frightening and thanks again for this useful information and kind regards from Kristina. :grouphug;
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Bach was no pioneer; his style was not influenced by any past or contemporary century.
  He was completion and fulfillment in itself, like a meteor which follows its own path.
                                        -   Robert Schumann  -

                                          ...  Oportet Vivere ...
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