Diagnosed With Polycythemia Vera. Recently After Increase In Dosage, Feel Kidney Pain. Fear Of Failure Due To Gout?

Posted on Sat, 16 Jun 2012

Question: Hi, I was diagnosed with Polycythemia Vera about two years ago, and have learned that gout comes with it. I take Hydrea, and allopurinol. It works great, I generally feel ok. However, familt doc raised my crestor from 10 to 20 mg. I immediately had kidney pain. Stopped the drug and told doc. He changed my statin to pravastatin sodium, 40 mg. I am afraid to take such a high dose. Don't want it to damage my kidneys, knowing I have gout. Also, don't want it to interfere with the effectiveness of my PV meds. My blood count went high when I was on the 20 mg crestor, and i had to have a Phlebotomy that time. Normally, my meds keep the count in control.
Thanks for help. I am age 70 female.

Answered by Dr. Avinash Ignatius (17 hours later)

Hello,

Thanks for the query.

Hydroxyurea (Hydrea) is an accepted treatment for polycycthemia vera (PV). And you are right, most patients develop high uric acid levels during treatment with hydrea; allopurinol is also right.

Im not sure why you are on Rosuvastatin (Crestor) as it is neither part of treatment of PV nor for high uric acid. However if you are on a statin, there is no direct risk to kidneys. But statins are known to cause rhabdomyolysis (muscle necrosis). Severe rhabdomyolysis can cause acute renal failure.

Milder case of rhabdomyolysis may only present as muscle weakness and pain. Elevated blood level of CPK (creatinine phospho kinase) would suggest rhabdomyolysis. So if you develop muscle pain / weakness, it would be wise to get your serum CPK levels checked and visit your doctor to initiate measures that could prevent renal failure.

Hope this answers your query. I will be available to answer any follow up query. Please accept my answer if you do not have any further queries.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Avinash Ignatius (5 hours later)

Sorry I didn't mention, I have high cholesterol, and when I couldn't take the 20 mg cholesterol, my family doctor, not my Hematologist, prescribed 40 mg of pravastatin
sodium instead. I am afraid to take such a high dosage. I was happy that you clarified why my blood count probably went higher when I had pain in kidneys.
I am moving to another city next month, and will be going to a new family doctor then. I will ask him to consider this problem before deciding what to do about
the pravastatin. For now, I have been breaking the 40 mg tablets in half. I also am careful about diet. I do not usuallyt. I sometimes eat XXXXXXX or chicken, do not
drink milk. However, my diet is not high cholesterol. Thanks,
Marla XXXXXXX

Answered by Dr. Avinash Ignatius (1 hour later)

Hi,

Thanks for writing back.

Watch CPK levels, if you develops similar symptoms. Monitor your cholesterol every three months.

Wish you good health.

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Raju A.T