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Kidney Cancer: Urgent Immunotherapy and Kidney Function/High Creatinine

Alyrica
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  • 34 subscribers
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Hello,

Looking to get some advice quite urgently due to second cycle of immunotherapy scheduled for Thursday.

Had a radical nephrectomy in summer, following this kidney function eGFR was around 50.

Went on to begin adjuvant immunotherapy (Pembrozulimab), before the first cycle eGFR went up to 58 and creatinine stood at 115. About four weeks after first cycle of Pembrozulimab bloodwork showed that eGFR was 40 and creatine shot up to 156.

Concerned as I don't know how serious or how concerned I should be. Have struggled to get in touch with a doctor about this. Spoke to a member of oncology at the end of last week who said it will be monitored but not to worry as it's reversible. Issue is that next immunotherapy cycle is due to take place this Thursday and I don't know if I should have it or not. To summarise, some of my questions/concerns:

1) How serious is the drop in kidney function?

2) What should be happening now or is it more of a case of monitoring and waiting to see what happens?

3) Is there likely to be any damage or is it likely to be reversible?

4) Is this a side effect of immunotherapy? The member of the oncology team suggested that if it were related to immunotherapy it would've been a more drastic drop which I'm not sure I'm convinced by

5) Most urgently, should I be going ahead with immunotherapy with levels being where they currently stand?

Any advice appreciated!

  • Dear Alyrica,

    Thank you for getting in touch with us, and welcome to our online community. My name is Annerose I’m one of the Cancer Information Nurses here at the Macmillan Cancer Support line.

    It’s always a worrying time when you’re having cancer treatment, the uncertainty about what the future hold can be very difficult to cope with.

    I understand your concern is about the drop in your kidney function after your first cycle of Pembrolizumab, and whether you should go ahead with your next cycle this week on Thursday.

    Experiencing a change in kidney function after nephrectomy is not unusual. Side effect of Pembrolizumab can include inflammation of different organs including effects on the kidney.

    It is good that you have spoken to your team about your concerns already, as early detection can be the key to starting treatment for the side effects if necessary, as most are reversible.

    This is why everyone on anticancer treatment will have blood test before each cycle to assess, especially the effects on the white blood cells, liver, and kidney function.

    The outcome of the tests, and any necessary steps are usually discussed in the Multi-Disciplinary Team Meeting before the next cycle.  

    If necessary, steps can be taken such as treating the side effect and pausing treatment until it has resolved, or reducing the dose.  

    As we are not part of the NHS and have no access to your medical records, it is not possible for us to comment on your individual situation.

    However, please ask to speak to a member of your team before you have your next treatment, discuss your concerns in person and in detail, and maybe you can ask for a recheck of your bloods on the day, to see if there is a difference since the previous test.

    I hope this has been helpful, but please don’t hesitate to get back in touch if you need any further information or support.

    Best wishes and take care, 

    Annerose (Cancer Information Nurse Specialist) 

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

    Ref/ RC

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