You are here

Imatinib - Kidney issues - Creatinine high, EGFR low

Hi all

i received my blood results today after 12 months on Imatinib (400 daily). BCR-ABL keeps reducing which is good. But for the first time since starting the meds there have been some issues raised about my kidney function. Creatinine level is high at 110 (normal levels are utpo 110) and EGFR is low at 68 (normal is 90 and above). The Haemotologist said I am not at dangerous levels in these areas but this does now need monitoring. I am a bit concerned about how this plays out longer term given i have only been on imatinib 12 months and am 47 so will be on TKI's for many years to come. Does anyone have any experience of kidney issues on Imatinib. I really dont want to switch to another TKI as the Imatinib is doing a great job on lowering the BCR-ABL.

Any advice/thoughts would be appreciated

thanks

Joe

Hi Joe

Sorry to hear about this news. I was on imatinib for around 4 years and had my creatinine levels and EGFR tested twice during that time. Creatinine was 108 and 112. I was also concerned about this and, like you, was told by the haematologist that this wasn't at a dangerous level so I ignored it. I am going to be 47 in May.

I have read in a few places that imatinib can raise creatinine levels and that this is not a cause for concern provided it is monitored carefully. Here is an article that discusses this property:

https://pubmed.ncbi.nlm.nih.gov/26795084/#:~:text=Imatinib%20completely%....

I don't understand it as well as I should, but the key takeaway seems to be its conclusion: "imatinib increases serum creatinine independently of any glomerular dysfunction and is fully reversible on imatinib cessation." If I read this correctly, it means that imatinib has the tendency to raise the creatinine levels without any underlying kidney damage, and that the levels might return to normal on stopping. This is what happened to me. My latest test in 2024 showed creatinine back to 92.

As far as I understand it, the EGFR is actually calculated based on the creatinine levels, as well as several other variables such as age, sex, ethnicity, etc. So the low EGFR is calculated because of the high creatinine levels, which may not indicate that your kidneys aren't functioning correctly given that the creatinine might just be high because of the imatinib (but bear in mind I'm not a doctor!) Either way, if it were me I'd insist on monitoring this carefully in case you need to switch to another TKI somewhere down the line - given imatinib is working well for you and it's the least potent of the available TKIs, there's no reason to fear a change.

I hope this helps a little bit!

Best wishes

Martin

Hi Martin

thanks for responding so quickly. Its always reassuring to hear from someone has been in the same position and how it was handled. I, like you, made the link that the low egfr relates to the high creatinine levels but i will double check this. I am being referred for a kidney scan just to make sure it is the Imatinib and not anything else - but given the article you have sent and your own experience its highly likely to be the imatinib. I asked whether I would be able to remain on the Imatinib if the Creatinine levels remained where they are and the answer was a bit unclear - basically "we will need to monitor it". I just hope it doesn't go any higher and maybe i can reduce it a bit by improving my diet (more water, less red meat and salt) but not convinced that will make much difference as the Creatinine levels seem to have risen fairly quickly as they were at 90 in november 24.

cheers

Joe

I was diagnosed 10 years been on imatinib 400 mg per day since diagnosis.. I too have the same issue with the kidney function tests. My EGFR - was coming back at 49% and the locum gp telling me I had kidney failure. This is RUBBISH - imatinib can increase levels of creatine in the blood - get a CYSTATIN C test this will give you a correct reading.

thanks. that's interesting to hear -so have your creatine levels been high as well as having the low efgr- but you have been able to remain on imatinib? i am due to have a kidney scan soon but will ask about the cystatin c test - thanks for the advice

Joe