Experience 35 years of experience in the field of nephrology & hypertension. Emeritus Professor of clinical Medicine at a major medical school and director of Nephrology & Hypertension at a university affiliated medical center.
Question Dr. Falkinburg,
My husband had high blood pressure for years and now it is
under control with several medications. Over time, he developed kidney disease and diabetes. His 24-hour urine test indicated that he had 2400 mg of protein. His creatine level as of 4/14/08 is l.96 (.5-1.3 lab range) and GFR of 43 (61.117,), Clearance Calcium of 52. He was told that he would probably need to take Prednisone. What are the side effects for 80 mg. Are there clinical trials available to patients that have been done by the pharmaceutical company that first released Prednisone?
Thank you.
Bette
Answer Dear Bette,
Your husband has serious kidney disease and he needs, very much, to be under the care of a good nephrologist.
From the information you gave me, I cannot comment upon the appropriateness of prednisone in the treatment of his kidney disease. I would need biopsy information.
Having said that, he clearly has some form of glomerular disease and in some of these prednisone is appropriate. In others, however, it is useless. Diabetes can effect the kidneys and is a common cause of kidney failure in the USA. Prednisone would be ineffective in the treatment of such a disease if he were to have it.
Prednisone is a very powerful medication and 80 mg is a whopping dose. There are many side effects . It can cause personality changes, rarely psychosis; it can cause wasting of calcium into the urine and result in the development of osteoporosis; It suppresses the immune system and can make one infection prone; It causes weight gain with a weird distribution of fat.... around the middle of the trunk, the face and on the back between the shoulder blades. The limbs are spared. It causes diabetes in nondiabetics and aggravates diabetic control in the existing diabetic. It aggravates hypertension.
For the above reasons it should only be prescribed when absolutely necessary and managed be a nephrologist who knows what he's doing.
Prednisone has been around since the 1950's but there were no controlled studies looking at its effectiveness until the 1980's. These were not sponsored by the pharmaceutical company manufacturing the drug but, rather, by a collaborative effort involving many nephrology centers funded by the National Institute of Health. The findings were that prednisone is effective for certain forms of glomerulonephritis, ineffective in others.
The message for you to take away is that he needs immediate expert nephrology care to be sure that the prednisone is appropriate and that it is managed properly and that he gets off it as soon as possible.
Hope this is useful to you and thanks for the question.
