Kidneys and Urinary Tract

Protect your kidneys! They are precious filters. Damage to them can compromise future clinical trial eligibility as well as your quality of life. Contrast dye in CT scans and (less so) radioactive sugar water used in PET/CT scans can damage your kidneys, bladder etc. Stay well hydrated before and after scans. You want to avoid undergoing dialysis later in life.

Hydration

Staying hydrated is extremely important for reducing side effects and making yourself feel better. Dehydration causes malaise, weakness, fatigue, brain fog, achiness, low mood, headache and muscle cramps.  

Hydration also plays a key role in protecting your other organs  from drug treatment damage.

Recommendations

• DRINK DRINK DRINK!!! 

• Avoid caffeine or other fluids that can contain natural diuretics.

• Lemon water or water with fresh mint or cucumber slices helps make water more palatable.

• Diluted juices such as orange juice or apple juice work well.

• Bubbly water, La Croix, Spindrift

• Fresh Coconut Water contains electrolytes and potassium.

• Gatorade is helpful for electrolyte replacement, as is G2, which is lower in sugar.

• Oral rehydration mix (electrolyte balanced), is an option. You can mix it with juice (ie cranberry) to mask its taste.

• Citrus popsicles.

• Jello. Brothy soups.

Hyperkalemia / High Potassium Level

Hyperkalemia or high levels of potassium in your blood can occur if your kidneys aren’t working properly. It can also be an indication of kidney disease. Abnormal potassium levels can cause symptoms such as muscle cramps, nausea, diarrhea, fatigue, low blood pressure, confusion and can cause changes in heart rhythm if the values become too high. Blood potassium levels are in the normal range if between 3.6 and 5.2 millimoles per liter; a value over 7 can be dangerous. (reference WebMD and Mayo Clinic websites)

Recommendations

• Drink fluids; staying hydrated is very important. Fluids can help flush the excess potassium from your system. Reference Hydration section

• Don’t drink Gatorade or other such products as they have potassium added as an electrolyte.

• Avoid high potassium containing foods such as bananas, scallops, potatoes, figs, orange juice, meat / protein to name a few examples.

• Talk to your physician to monitor and manage your blood levels

Increasing Creatinine Values

Higher creatinine levels can indicate compromised kidney function.  Keep an eye on your creatinine levels and be aware if there is an increasing value trend over time. Keep a running log of the several key measurement values so as to more easily spot possible trends. Certain targeted therapies combinations (ie Alimta) can cause a slow increase over time in creatinine levels, which indicate stress and possibly damage to your kidneys. A targeted therapy (Xalkori) caused me to have an immediate jump in creatinine measurement values, but it is not known whether the increase is permanent or will drop back to a more normal range after drug therapy is discontinued. My creatinine values continue to be elevated, but my kidney function is now stable. 

Recommendations

• Be aware of scan substances (ie metals in contrast, etc.) as they can be toxic if your kidneys are compromised.

• Stay well hydrated before and after your scan; keep drinking to flush the contrast out of your system.

• Stay hydrated as dehydration can worsen your creatinine values as well as affect how you feel.

• Creatinine values / compromised kidney function can affect dosing and eligibility for certain clinical trials 

Urinary Tract Infections (UTI)

Because your immune system is dampened by either or both your cancer or cancer treatment you will be more susceptible to urinary tract infections. Having sexual relations will also increase the likelihood of this infection, especially for women; unfortunately several of us have noticed the correlation between having sex, which is later followed by getting a UTI. Talk to your physician about fighting the infection with antibiotics if you present with persistent symptoms.

Recommendations

• It is important to cleanse yourself before and after having sex with a mild soap and water rinse as using a damp cloth might just spread bacteria around the area.

• Cleanse yourself front and back to minimize the presence of normal flora, bacteria.

• After having sex, pass urine to cleanse the urethra.

• Consider using a bidet routinely or purchasing a personal hygiene modification for your toilet or shower.

• Drinking 100% cranberry juice may help flush bacteria out of your bladder as this unique juice’s composition makes it more difficult for bacteria to stick to the bladder’s inner walls and urethra.

• Ask your GP for an antibiotic prescription if the symptoms persist longer than a few days.