26th March 2004
I just got copies of more of my lab results and discovered that my creatinine went from 0.9 in January to 1.7 in March. That is almost double!
One thing that was changed was my blood pressure medications, so I am suspicous of them. The warnings for Adalat say:
Laboratory Tests
Rare, usually transient, but occasionally significant elevations of enzymes such as alkaline phosphatase, CPK, LDH, SGOT, and SGPT have been noted. The relationship to nifedipine therapy is uncertain in most cases, but probable in some. These laboratory abnormalities have rarely been associated with clinical symptoms; however, cholestasis with or without jaundice has been reported. A small increase (4%) in mean alkaline phosphatase was noted in patients treated with ADALAT CC. This was an isolated finding and it rarely resulted in values which fell outside the normal range. Rare instances of allergic hepatitis have been reported with nifedipine treatment. In controlled studies, ADALAT CC did not adversely affect serum uric acid, glucose, cholesterol or potassium. Nifedipine, like other calcium channel blockers, decreases platelet aggregation in vitro. Limited clinical studies have demonstrated a moderate but statistically significant decrease in platelet aggregation and increase in bleeding time in some nifedipine patients. This is thought to be a function of inhibition of calcium transport across the platelet membrane. No clinical significance for these findings has been demonstrated. Positive direct Coombs’ test with or without hemolytic anemia has been reported but a causal relationship between nifedipine administration and positivity of this laboratory test, including hemolysis, could not be determined. Although nifedipine has been used safely in patients with renal dysfunction and has been reported to exert a beneficial effect in certain cases, rare reversible elevations in BUN and serum creatinine have been reported in patients with pre-existing chronic renal insufficiency. The relationship to nifedipine therapy IS uncertain in most cases but probable in some.
I don't like the "rare reversible elevations...in patients with pre-existing chronic renal insufficiency". I could handle the reversible part of it, but the pre-existing side is what gets me! :-(
Also, all of the other items that were off in the March report were fine in January, so I wonder what went on. I did start feeling pretty awful (weak and easily fatigued) in Feburary and am still having problems with that, so maybe the levels are related to that.
Well, I would appreciate any insights, but guess I will mostly find out next Tuesday. Or at least be on the road to finding out, as you never seem to learn anything on the first visit. :-) I am going prepared, with copies of lab reports, etc.
Blessings,
Ramona
One thing that was changed was my blood pressure medications, so I am suspicous of them. The warnings for Adalat say:
Laboratory Tests
Rare, usually transient, but occasionally significant elevations of enzymes such as alkaline phosphatase, CPK, LDH, SGOT, and SGPT have been noted. The relationship to nifedipine therapy is uncertain in most cases, but probable in some. These laboratory abnormalities have rarely been associated with clinical symptoms; however, cholestasis with or without jaundice has been reported. A small increase (4%) in mean alkaline phosphatase was noted in patients treated with ADALAT CC. This was an isolated finding and it rarely resulted in values which fell outside the normal range. Rare instances of allergic hepatitis have been reported with nifedipine treatment. In controlled studies, ADALAT CC did not adversely affect serum uric acid, glucose, cholesterol or potassium. Nifedipine, like other calcium channel blockers, decreases platelet aggregation in vitro. Limited clinical studies have demonstrated a moderate but statistically significant decrease in platelet aggregation and increase in bleeding time in some nifedipine patients. This is thought to be a function of inhibition of calcium transport across the platelet membrane. No clinical significance for these findings has been demonstrated. Positive direct Coombs’ test with or without hemolytic anemia has been reported but a causal relationship between nifedipine administration and positivity of this laboratory test, including hemolysis, could not be determined. Although nifedipine has been used safely in patients with renal dysfunction and has been reported to exert a beneficial effect in certain cases, rare reversible elevations in BUN and serum creatinine have been reported in patients with pre-existing chronic renal insufficiency. The relationship to nifedipine therapy IS uncertain in most cases but probable in some.
I don't like the "rare reversible elevations...in patients with pre-existing chronic renal insufficiency". I could handle the reversible part of it, but the pre-existing side is what gets me! :-(
Also, all of the other items that were off in the March report were fine in January, so I wonder what went on. I did start feeling pretty awful (weak and easily fatigued) in Feburary and am still having problems with that, so maybe the levels are related to that.
Well, I would appreciate any insights, but guess I will mostly find out next Tuesday. Or at least be on the road to finding out, as you never seem to learn anything on the first visit. :-) I am going prepared, with copies of lab reports, etc.
Blessings,
Ramona