Disclaimer: To protect patient privacy, this question has been edited slightly to omit identifying details.
A Patient Power user with chronic lymphocytic leukemia (CLL) asked: “Are there any new treatments for people whose kidneys may be damaged by previously annual urinary tract infections (UTIs)? How would anyone know if the kidneys could be okay for CLL treatments, beside measuring GFR (glomerular filtration rate) and creatinine clearance? Is that not just a measure of what remains functional of the kidneys?”
“The typical way to measure kidney function is with a blood test for creatinine,” said Kerry Rogers, MD, from The Ohio State University Comprehensive Cancer Center – The James. A creatinine test measures how well your kidneys are filtering waste from your blood.
“In some cases, where it is important to understand kidney function with a greater degree of accuracy, a 24-hour urine collection can be done, but there is usually no need to do tests beyond the serum creatinine, which is used to estimate both GFR and creatinine clearance,” Dr. Rogers said.
“There are plenty of treatments that can be used to treat CLL in people with decreased kidney function,” Dr. Rogers said. “I have even treated people who are on dialysis.”
“The BTK inhibitors (ibrutinib, acalabrutinin, and zanubrutinib) are used in people with kidney impairment, and some have dosing recommendations for even quite severe kidney damage,” Dr. Rogers said. Also, “there are a few other options as well such as anti-CD20 antibodies like rituximab and obinutuzumab.”