prednisone and dialysis

[brenda seal]

Firstly Laurie deteriorated and had to take him to emergency last night . they have admitted him to renal ward . Blood tests have shown besides creatinine and urea etc being high - all inflammatory markers are very much higher so arthritis very active . Laurie takes prednisone for his arthritis and I was just wondering if it is possible the dialysis is ridding it from his system before it has chance to do it's job. Does anyone else suffer from rheumatoid arthritis or take prednisone for another condition that could enlighten me ?
Brenda

[Traveller1947]

Hi, Brenda.  I'm so sorry to hear that Laurie is worse again.  I can only tell you my personal experience: six months into hemodialysis, I developed a fever that couldn't be explained.  My nephrologist sent me to an infectious disease specialist, who also found nothing.  As an 'experiment', he had me take a high dose of prednisone for six months.  It knocked the fever out, showing that the cause was inflammatory. From there, on to the rheumatologist...  During that time of course, I had dialysis as usual and it didn't prevent the prednisone from doing its work.   Hope this is helpful.  All the best to Laurie and to you.

[jeannea]

I don't know that prednisone is eliminated during dialysis. I've been on it since my first transplant. When I started dialysis they told me which meds to save for after my treatment and prednisone was not mentioned. I think it's more that he's just really sick so everything is worse. I'm sorry he is feeling worse but I'm glad you got him admitted. I hope they can help him.

[Annig83]

I'm going through the same thing. My markers are INCREDIBLY HIGH!! My doctor thinks I have lupus, but I'm not starting on any medications yet.  From what I understand when speaking with my doctor, the Predinsone is NOT removed from dialysis. In fact they tell you to watch the dosage of Predinsone because it causes weight gain and thus cause fluid retention.  Predinsone is processed by the liver, not the kidneys...  I was on it for some acute liver issues a few years ago. 

Hope Laurie feels better soon! All the best.

[smcd23]

Yes from what I understand also prednisone is not cleared by dialysis. My SO is seeing a rheumatologist for joint pain, and they determined he had gout (inflammatory markers were high as was uric acid but not as high as they'd expect in someone with gout) It gets worse when he is dehydrated - how is Lauries hydration? The rhuematologist wants my SO on prednisone but they are afraid it will raise his blood pressure because it will make him retain fluid and mess with his immune system while he waits for a kidney (and he's hopefully close)

[brenda seal]

Thank you everyone for taking time to rep;y to my post . Laurie has improved , they have increased his volume  but he cannot tolerate more than 1500ml per fill without great discomfort . He is still very weak but has managed to walk to the bathroom a couple of times and he is eating a little . BP still very low so they have stopped his meds and halved his dose of lasix .
He was upset and cranky today - patient in the next bed gravely ill and his family were there all night and also a priest administering last rites . He was upset also as the nurses weighed him and he has lost another bucket load of weight and is down to 67kg .
the neph confirmed dialysis does not clear prednisone but has no answers as to why his rheumatoid has worsened since starting PD .
smcd23 , Laurie was dehydrated when admitted to hospital as he had been vomitting but rheumatoid has been steadily worsening since starting dialysis in February . When he moves his neck or shoulders it sounds like the floorboards are creaking . I hope your SO does not need to start prednisone and gets a transplant very soon .

[Rerun]

What is a  "SO"??

They cannot just stop prednisone.  It will do a number on him.  They need to taper off of Prednisone.

[brenda seal]

Rerun SO is significant other - another thing I have learned from this site ! No , indeed they can't just stop the prednisone as he has been on it for over twenty years . The issue at the moment is that his current dose of 10mg daily is not helping his rheumatoid and also as he has been so sick " they " are considering  whether this dose is enough replace the adrenal gland . The 10mg for the last few years has been the minimum he can function on in terms of his pain and mobility .
His kidney specialist and his rheumatologist work out of different hospitals and never the 'twain shall meet !
Brenda