Kidney function

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Hi everyone. I am having pembrolizumab treatment for stage 3a RCC. Right kidney was removed last July 2024

The doctor phoned this morning and said my gfr has fallen from 45 to 37 in the last 6 weeks.

He said that it wasnt a problem and that I should drink more. I queried this and asked for a break in treatment for a month to see if the gfr improved.

Anyway, the consultant left a message that the kidney function was OK and I should have the next treatment which is tomorrow.

So I dont know what to do,

Any advice?

Mmum 18 hours ago

There is a known issue with some people having immunotherapy treatment (pembro being one) and a drop in eGFR. I had it with ipilimumab and nivolumab. My consultant withdrew the treatment when my eGFR got to around 28. Previously was above 60. I went on a course of steroids, the eGFR gradually improved and I tried the nivo again and it was ok. eGFR taken a permanent hit though and "normal" is now in the 50s.

However, there is also a connection between better long term outcomes for those who experience immune related adverse events like this.

From what you've written in your post it's not clear whether the phone message is saying it's recommended to have the treatment despite the eGFR, or whether the eGFR is now improved back to normal so fine to proceed.

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Kidney function