Estimating Glomerular Filtration Rate (GFR)- Is There A Pharma Bias?

yerrag

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My mother's current round of return trips to hospital confiment has led me to question whether the dosage of drugs she has been receiving is appropriate for her profile - short, thin Asian elderly woman in her 90s, and I have started to look at how the hospital doctors estimate the GFR of patients to arrive at the dosage rate of drugs being administered.

I got into looking at this because I was perplexed at how her mental condition took a dive - insomnia, restlessness, disorientation, drowsiness, not eating and drinking, etc. - and this was never explained by the doctors except pointing to her old age as a cause and making her condition a fait accompli, so that we could start accepting putting her on pallative care or on a hospice. It seemed so very convenient. And I was prepared to accept that.

Luckily, a psychiatrist whom I requested for to diagnose my mom, prior to her discharge, was very helpful. He pointed out to the administration of a fluoroquinolone-based antibiotic called Levofloxacin, and said that she could be experiencing the side effects. My mom was discharged, and I was hoping the side effect would go away in a few days. But it never did. And my mom was readmitted having eaten and having drank so little to the point that her blood pressure plunged. She was dehydrated and IV was administered and she was given an antibiotic again to help her through the stressful period.

It was then that I started to look further into Levofloxacin, and what my searches revealed was that there is a long trail leading to Levofloxacin and its ilk, of side effects that are so severe and long-lasting that would affect the nervous system, as well as tendons.

I started asking why this drug was used on my frail mother, given that it has such a long history of lingering and debilitating side effects, that enough complaints had been made by consumers in the US leading to the FDA issuing a "black box warning" on the labels, which is the highest level the FDA can give before a product is pulled out of the market. The picture would not be complete without my mentioning that over the years many antibiotics of the fluoroquinolone class had been pulled off the market. This should give any well-meaning doctor enough pause when considering giving anybody, much less a frail elderly woman, such a drug.

But any mention of the side effect to the doctors in the hospital I'm in contact with would be met with dismissive trivializing with statements such as "anything is possible." That really got my ire, as they have the gall to equate something highly probable to being something on the level of "anything is possible." Well, the sun may sink today. That is possible. But no one should worry about it, right?

I then got the information packet, the sheet of thin paper with very small fonts that explains everything on the the use of the drug Levofloxacin. It also showed me how dosage levels are determined, and it is determined by the estimated glomerular filtration rate (eGFR), which is related to how well the kidney filters blood going through it.

The choice of formula on estimating the eGFR determines largely, if not solely, the dosage rate of the drug.

On the information sheet that came with the Levofloxacin IV fluid bottle, it gave me a formula, called the Cockcroft-Gault, which I used to determine the eGFR, which came out to be a value of 18 ml/min. With this value, I would look at a table that would show me that my mom would need to dosed with 250mg of the drug daily.

However, when I asked the doctor who administered the drug how he arrived at a dosage that's twice the rate I had determined above, he told me that he is using the CKD-EPI formula, which he justified using at the literature shows that his formula is superior to the formula I used.

His eGFR using CKD-EPI came out to 32 ml/min, which almost twice the eGFR value under Cockcroft-Gault at 18 ml/min. Under his eGFR value, he was fully justified in using the 500mg daily dosage rate.

I looked at the literature again in the internet, and I could not find anything to refute him.

Certainly, the best way to prove him wrong is to take an actual GFR value by taking a day's worth of urine, and running it through some tests to determine the actual GFR. But that would be hard to do, given my mom suffers incontinence, and wearing diapers means it's harder to collect urine.

But what if the study or studies that had conclusions stating CKD-EPI as being superior is biased by pharma? Certainly pharma companies have incentive to pump up the eGFR values in order to double the dosage rate, so that its sales would double. Is there any literature out there that I'm not privy to that could refute the generally held idea that the CKD-EPI method is superior than all the rest of the eGFR formulas, especially for the subset of elderly population to which my mom belongs?
 

Nikki

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I can't answer your GFR questionm but wanted to add to your complaint about fluroquinolones.

My father was also nearly murdered by fluroquinolone-happy doctors. The first time he took cipro was when admitted to the hospital for a UTI. After 4 or 5 nights in the hospital (on Cipro), they sent him home unable to walk, and suffering from halucinations. Before checking into the hospital, he was walking 1 mile once or twice a day and living independently. He never did recover to where he could walk again without a walker or take care of himself. Kaiser Permanent, his HMO, delivered him to his house without a wheelchair and didn't tell any of us that he had lost his ability to even stand. According to his hospital record, he was unable to walk after about two days of treatment with Cipro.

I read that fluroquinolones can interfere with the way the brain communicates with the muscles. This may be why my dad could walk one day, but not the next. To make a long story short, dad went on 3 more courses of fluroquinolones and had the same reaction each time. However, we did not know the cause and no doctor suggested it could have been the antibiotic. The 4th time he began a course of fluroquinolone, he became unable to walk, severely confused and extremely sore after just one dose. I mistakenly gave him a 2nd dose before calling the nurse for advice. It was while I was putting the pill in his mouth that i made the connection. I cannot understand exaclty what happened to him, but I saw it happen four times. After I explained to his doctors, they still wanted to give him Cipro! I had them mark on his chart that is was an allergen and they STILL sent him home with a bottle full of it a few months later. It's a good thing I saw the bottle before his caregiver gave him a dose.

It's become clear that the government doesn't want old people sapping up resources.
 
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yerrag

yerrag

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I can't answer your GFR questionm but wanted to add to your complaint about fluroquinolones.

My father was also nearly murdered by fluroquinolone-happy doctors. The first time he took cipro was when admitted to the hospital for a UTI. After 4 or 5 nights in the hospital (on Cipro), they sent him home unable to walk, and suffering from halucinations. Before checking into the hospital, he was walking 1 mile once or twice a day and living independently. He never did recover to where he could walk again without a walker or take care of himself. Kaiser Permanent, his HMO, delivered him to his house without a wheelchair and didn't tell any of us that he had lost his ability to even stand. According to his hospital record, he was unable to walk after about two days of treatment with Cipro.

I read that fluroquinolones can interfere with the way the brain communicates with the muscles. This may be why my dad could walk one day, but not the next. To make a long story short, dad went on 3 more courses of fluroquinolones and had the same reaction each time. However, we did not know the cause and no doctor suggested it could have been the antibiotic. The 4th time he began a course of fluroquinolone, he became unable to walk, severely confused and extremely sore after just one dose. I mistakenly gave him a 2nd dose before calling the nurse for advice. It was while I was putting the pill in his mouth that i made the connection. I cannot understand exaclty what happened to him, but I saw it happen four times. After I explained to his doctors, they still wanted to give him Cipro! I had them mark on his chart that is was an allergen and they STILL sent him home with a bottle full of it a few months later. It's a good thing I saw the bottle before his caregiver gave him a dose.

It's become clear that the government doesn't want old people sapping up resources.
Hi Nikki, I hope your dad can still recover from it. And I can share with you my experience in restoring my mom back to normal after seeing what Levofloxacin did to her. It's useless wasting efforts on helping people who don't have exposure to Ray Peat, they will listen to the doctor and that's the end of story for them. If your dad can still eat, that's good. Continuing on fluoroquinolones will eventually lead to loss of sensorium, and that means a person cannot eat anymore. Putting a person on NGT or PEG will be needed, but that is a very sad way to spend one's life. That was what happened to my dad.

Incontinence is a real problem with old people. And UTI comes with it. I'm looking into using some anticholinergic drugs that may help in restoring muscle control of the urinary sphincter. I still haven't decided on one, but I believe that it can help my mom.

My mom got released from the hospital after I applied Peat principles on her, thru her food, which was the only way I could sneak in supplements into her without having doctors see what I was doing. I didn't want to discuss what I was doing, as there was no point to doing that with them. I strongly believe now that if we depended on our doctors, nothing will happen and we will be helpless. But if we understand our body well and know what ails it and what can really fix it, without surgery and side effects, we can restore many functions that we once thought are lost with old age.

I'll work on getting rid of her incontinence first, and then on restoring her hearing.
 
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Nikki

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Hi. My dad was able to eat each time he went through this issue on the fluroquinolones (let's just call the FUQ's since that's what they do).

Is your mom on progesterone? I think that can help a lot with incontinence. If the anticholinergics work, let me know because I know a lot of elderly people who would love to ditch their diapers.

To prevent UTI, my dad takes 2 tbsp twice a day of mesosilver. It has worked beautifully for the last couple of years. I take 1tsp twice daily (I am petite) and avoid the flu (and who knows what else) with this dose. My friend's mom is given a large dose of buffered vitamin C at night on an empty stomach and that is reportedly controlling her UTIs. Controlling UTI is very important in the elderly. People don't realize how much a UTI can affect an elderly person's mentation.

I wonder if low dose naltrexone would be helpful for incontinence.
 
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yerrag

yerrag

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Hi. My dad was able to eat each time he went through this issue on the fluroquinolones (let's just call the FUQ's since that's what they do).

Is your mom on progesterone? I think that can help a lot with incontinence. If the anticholinergics work, let me know because I know a lot of elderly people who would love to ditch their diapers.

To prevent UTI, my dad takes 2 tbsp twice a day of mesosilver. It has worked beautifully for the last couple of years. I take 1tsp twice daily (I am petite) and avoid the flu (and who knows what else) with this dose. My friend's mom is given a large dose of buffered vitamin C at night on an empty stomach and that is reportedly controlling her UTIs. Controlling UTI is very important in the elderly. People don't realize how much a UTI can affect an elderly person's mentation.

I wonder if low dose naltrexone would be helpful for incontinence.
My mom's not on progesterone at all. I'll try it out soon. Maybe I should try it first before using anticholinergics. Haven't used any pharma-like stuff, but I should try some.

I have my mom on d-mannose and it also works. But I should try mesosilver. Where do you buy it from? It sounds familiar as I must have seen its ads, maybe from Mercola or from Naturalnews. I agree about controlling UTI. It seems to me it's the most important, as even healthy people can't seem to avoid it once incontinence starts.

I'll do a search on this forum on naltrexone then. Thanks.
 
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yerrag

yerrag

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Started my mom on progesterone.

She had an IV antibiotic therapy of Ertapenem for UTI for a week.

Gave her 4 drops 3x a a day and a half after her IV therapy finished. She was having difficulty sleeping before that, and Progestene got her sleeping continuously for a day. During that time, her temperature increase from 36.3 to 37.7 and her blood pressure went up from 130/70 to 180/100. It eventually subsided and temps and bp went down after peaking.

She slept the next night and I thought she was over the effects of antibiotic therapy. But then didn't sleep the next night. Upon which I resumed Progestene at 3 drops 3x/day.

Will still have to observe her to see if the Progestene is improving her condition of incontinence. But during all this time, my mom has been showing signs of schizophrenia, a known side effect of using Ertapenem. So that this point, my effort is first directed towards dealing with the schizophrenia, and hope Progestene is helping. She is also on niacinamide, magnesium, egg shells for calcium, aspirin and taking them with a milk blend of eggs, whey protein, colostrum, and collagen hydrolysate, with virgin coconut oil and coconut nectar for sugar.

I have Cyproheptadine and Lisuride (to counter the drowsy effect of Cyproheptadine as an antihistamine) on hand, but not in a rush to use them while I observe the efficacy of Progestene.
 

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