Chemotherapy and Dialysis: Looking for others who have had both

We try for the 64 ounces. He works outside a lot so sometimes more in summer. It’s my dad. I might have said my husband. My dad was diagnosed with kidney cancer in April and my husband was diagnosed with colon cancer 2 weeks later. So I am all over the place.

@mmmartin The general rule of thought is 8 glasses of fluids a day, totalling about 64 ounces. Sometimes as kidney patients we need to reduce that somewhat, but not enough to get dehydrated. Do you know how much your husband gets in a day, for fluids?
Ginger

We have pushed fluids with him because we thought that was good for the kidneys. Is that the wrong thing??

Thank you for being so generous with your time and knowledge.

@mmmartin Have him watch his fluid intake so he doesn't overtax his kidneys. Also, watch his intake of salt, phosphorous, potassium, calcium, and protein. The goal is to not stress the kidneys as they try to do the job they are supposed to do.

If he is on medications, can you get a review by a pharmacist to see if there are any he should be wary of, that may be causing side effects either alone or in combination with others?
Ginger

Oh I’m so grateful for the response. I feel very alone in this. He has had CKD for a decade at least. So did my grandmother. I am not sure we really know why. The cancer was found incidentally last month when he was admitted to the hospital for a UTI. His baseline eGFR has been in the mid to low 20s for a long time. But the UTI plunged him to a 9. They released him when it got to 20, but it isn’t holding steady. So I am unsure what to do between now and the oncology appointment.

@mmmartin Welcome to Mayo Clinic Connect.

You don't mention the root cause of your father's CKD. Has the eGFR trend downwards been dramatic more recently? I hope the nephrologist has already approached your dad with information on dialysis and the different modalities, what to expect, etc.

I would suggest the following: Ask the nephrologist to get a background letter over to the oncologist, explaining your dad's current situation, before that June 16 appointment. That way information is hopefully already at hand. Ask for cooperation and communication between the two clinics, to coordinate care.

In my experience, my nephrologist and oncologist communicate via emails back and forth as needed, being in two different practices and records management systems. We all work together to coordinate the best plan for my treatment, which may not be the same for the next person. You don't mention your dad's age, your general location, or details about his kidney cancer. Unfortunately these days we need to be our own advocates, to make sure the care we receive is the best for us as a patient.

Please let me know if this has been any help to you, and if you have more questions?
Ginger

Hello. I am searching for direction and came across this. My dad is experiencing a gradual decline in his eGFR. He has had CKD for a long time, but we are now creeping into dialysis territory. Two weeks ago it as at 17 and we will get most recent report back Tuesday. Unfortunately, we have also recently found out he has kidney cancer. We have his first oncology appointment on June 16. I don't know if he will make it that long before his eGFR gets so low we have to intervene. His nephrologist and oncologist are at two different hospitals. Any advice or experience on how to handle this would be greatly appreciated.

@oregonami58 I am glad you will be eligible to car-t. Have you figured where you will go? Knight Cancer in Seattle or OHSU perhaps? Unfortunately, I am not a good candidate for either stem cell or Car-T. This definitely gave me pause, and changed my mindset. Knowing I am living with these two conditions that are my present and future realities, it is to embrace each day as a gift.

Yes, staying strong is my goal. and hoping it is yours, also!
Ginger

Ok so you are down the road from me here in Bend. I get my weekly infusion at St Charles medical center.
At some point in the future whe revlimid becomes less effective I will be eligible for car-t. Will that be an option for you?
I hope your new treatment plan has great results. Keep staying strong!