Patient's Query
Hello doctor,
My mom is 71 years old and has had rheumatoid arthritis for about 12 years now. Recently, her rheumatologist found that her creatinine levels are at 1.6, and her cardiologist is also concerned about some mild heart failure she was diagnosed with earlier this year.
The problem is both doctors keep adjusting her meds, and she feels like nobody is talking to each other about her full situation. Her CRP is also still elevated at 18 mg/L even with Methotrexate.
How does a 71-year-old manage RA alongside heart or kidney conditions when the treatments for one seem to make the other ones worse?
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
I am sorry that your mother and your family are dealing with such a complicated situation. Managing rheumatoid arthritis alongside kidney disease and heart failure can be challenging because some medications that help control inflammation may need dose adjustments or may not be the best choice when kidney function or heart function is affected.
A creatinine of 1.6 suggests that her kidney function should be carefully monitored, especially at her age, and persistent inflammation with a CRP of 18 mg/L indicates that her rheumatoid arthritis may not be fully controlled.
The most important step is having her rheumatologist, cardiologist, primary care physician, and, if needed, a nephrologist work together to create one coordinated treatment plan. Controlling the inflammation from rheumatoid arthritis is important because ongoing inflammation can increase the risk of heart disease, but treatment needs to be balanced with medications that are safe for her kidneys and heart.
Regular blood tests to monitor kidney function, liver function, blood counts, and inflammatory markers are essential, and her doctors may consider adjusting the methotrexate dose or discussing other disease-modifying medications or biologic therapies if appropriate for her overall health.
She should also avoid medications such as NSAIDs (non-steroidal anti-inflammatory drugs) or pain relievers unless specifically approved by her doctors because they can worsen kidney function and heart failure. Encourage her to keep an updated list of all her medications and bring it to every appointment so each specialist has the same information.
I hope this helps.
Thank you and take care.
Regards.
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