Day -12: Go Kidneys Go

Zoe had her 3rd GFR this morning, a follow-up on previous tests to determine kidney function. It involves injecting a radioactive fluid into her central line, then testing how long it takes to process. They take two blood levels after a delay, check how much remains in her blood stream, and from that we can tell how well her kidneys are functioning.

Zoe’s last GFR reading was 49, which essentially means she was running on 1/2 kidney function. What we didn’t know is whether that was a temporary problem, a permanent one, or even if it was part of a continuing decline.

Today we know the answer, it was temporary. Her GFR today came back 66, which means she’s regained improved about 30% over where she was. It’s great news, but the most important part is that she is improving, not deteriorating. This would seem to indicate Dr. P was right that the previous GFR results were directly related to her Cyclosporine use. He couldn’t promise that we would see her kidney function return (ever) after stopping Cyclosporine, but now we know that it has.

Go Zoe!

Next week, is a big week, we’ll be doing her last week of pre-conditioning and be admitted in advance of her Stem Cell Transplant. More on that Monday.

Day -14

No big changes today. We went in for a brief clinic visit to do blood counts and vitals, the big news from that is that Zoe’s blood pressure continues to be solid (90/60) off of her BP medicines. This continues to give us hope that her kidneys have or are recovering from her prolonged cyclosporine use. We’ll be doing a new GFR (kidney function test) on Friday, and then we’ll know more.

‘Til then, here’s Zoe playing with her favorite toy.


Cyclosporine & Sodium, Updates

It’s Monday and we’re back to the day hospital at Duke. Today was blood draws and a redo of the GFR kidney function test.

On Friday they took a Cyclosporine level and it was really high, 590 or so, which is much too high for Zoe. It’s a bit of a mystery, since we haven’t changed her dose and, after much hand wringing, feel sure that nothing happened to give her too much. We just don’t know how it could be that high. Normal therapeutic range is 150-250.

She did get a dose just before the test was taken, and we’ve seen in the past that that can amp the results up considerably. We got a reading in the 400’s awhile back after she had a dose just before the test, but 590 is just very high.

So, she’s off Cyclosporine, probably for good now since it is not a part of her conditioning regimen.

We retested some levels today along with the GFR, and found that it was still at a therapeutic level, 112, despite being discontinued days ago. Her GFR was not improved, still about 50 (100 is what we want), but the feeling is that the continued presence of Cyclosporine is keeping it down.

On a positive note, her Sodium has gone up to 137. It’s been down throughout her entire treatment, ever since she began her chemo, but we did no have a reason for it. It would now appear that the Cyclosporine was causing low Sodium for Zoe for some reason.

This doesn’t change much for us, we still proceed ahead, but we’ll be monitoring her kidneys via other markers as we go.

Tomorrow is another spinal tap and bone marrow aspiration, another meeting with the transplant team, then home for the week we hope.