Do Prolia injections affect the kidneys?

I am trying to figure out how one knows the right time for the switch. If the blood test says it is too soon, are the tests repeated every week until the timing is right? Or monthly? Or is the best guess made on one set of tests.

Thank you.Sounds too good to be true but terrific info and advise

@normahorn great question about the testing protocol for the switch from Prolia to Reclast. The standard timing is 6 months but both Keith McCormick and my doctor say it is trickier than that, as was discussed above.

From McCormick's book "Great Bones": he recommends CTX assays at 4-6 week intervals. That is the only way, he says, to assess whether and when the effects of Prolia have worn off. If the CTX remains steadily low, the Prolia is still working. Reclast would not work if Prolia is still active, but if Reclast is too late, bone loss might already occur. You do Reclast whe CTX levels rise.

Of course it can take 2-4 weeks to schedule the infusion, which is a problem!

He further says have another CTX test one month after Reckast and again 3-6 months later. If CTX levels continue to rise, another Reclast infusion might be needed. He says that sometimes there is an initial beneficial lowering of CTX the first month after Reclast and then a "dramatic rise" 3 months later, "indicating rapid bone loss." Hence a need for another infusion. "The key to successful transition is to do multiple CTX assays." pg 449-450

I have diabetes, osteoporosis, a history of hyperthyroidism and chronic kidney disease (CKD) stage 4. My medical team includes a primary, an endocrinologist and a nephrologist. The endocrinologist diagnosed the osteoporosis around the time I was being treated for hyperthyroidism. She did some bone density tests and prescribed Prolia. At that time I asked if it would be approved by my nephrologist. It was. I have a Prolia injection every 6 months at a nurse visit appointment.

@cehunt57 Reclast and bisphosphonates in general seem to be the concern for my nephrologist. So you will probably stay on Prolia since you cannot stop without Reclast or alendronate.

@windyshores I just had labs today to prepare for a nephrology appointment next week. My nephrologist has never said anything about Reclast or bisphosphonates. He did approve Prolia years ago when my endocrinologist prescribed it. I will ask again at my appointment next week.

@cehunt57 my nephrologist said that Reclast can cause kidney failure in rare instances. Her words were "It's rare, but devastating when it happens."

My endocrinologist is going to do a 20% (1 mg rather than 5mg) dose of a Reclast infusion as a test dose. After three months I will have a dose of my choice. I read that a half dose is as effective as a full dose so I am never going to request more than 2.5mg. This might be a way for you to go as well.

Thank you. I see nephrology next week and endocrinology next month. I will run this by both of them. Could you keep me posted on how this works out for you?

So sorry too hear all your going through. Although I haven’t had your severe side effects, I have had serious mouth issues. Failed bone graft, infections, pain & no longer can eat or bite in the front or left side of my mouth. I went too several specialists & they took me off Prolia. Then Forteo! I called Lily regarding Forteo about the high cost & they wouldn’t help. So Evenity was my last option. Just had my first two injections. What are these drug companies doing too us? The side effects are bad no which drug you choose. My Rheumatologist told me I’m damned if I do & damned if I don’t! Hope you feel better & I wish you the very best!

My docs say Forteo isn't effective after Prolia. I hope Evenity works for you @lab54