Jardiance for stage 3a CKD or Acute Kidney Injury (AKI)

Hi,

I just found this thread which I think could be helpful for me as I make a decision about starting Jardiance. I have a very rare CKD--perhaps one of ten people in the world with idiopathic ITG and one of about 100 with one of three variants of the disease (the others have either lymphoma (70%) or myeloma (30%). I was diagnosed in 2021 by a pathologist in the lab in the Nephrology and Hypertension Dept. at Mayo in Rochester after the pathologists at Healthpartners and the Hennepin County Hospital passed my biopsy sample to her. Because she publishes on ITG, I made contact with a nephrologist/hematologist at Mayo who had been a co-author on a paper. He is now part of my care team.

After two series of treatments, the first was judged to be ineffective, in 2021-2023, in October 2024, the team said I was likely in remission. That is to say, my symptoms and tests are not worsening. My eGFR is 69 but I excrete 2-3g of protein when I do 24 hour urine collections (most recently this week). The amount varies some which my local hematologist and nephrologist watch but have not provided instructions designed to alter.

I have a quarterly appt with the Mayo doctor next week. In April he ended my visit with an announcement that he wants me to start Farxiga via a prescription to be written by my local nephrologist. When I asked about side effects, I found myself wondering if it was worth all the new side effects. He said there are two that are the most common. The one I disliked hearing about the most is the sometimes fatal skin infections. I can't find info about how common those are. (My insurance doesn't include Farxiga in the formulary.)

The next most likely to be problematic side effect is the increased frequency of urination. I already spend quite lot of time in the bathroom in part because since my (infected, no stones) gall bladder was removed in 1977, I, like others I have met who no longer have a gall bladder, usually have 6 or 7 bowel movements a day. I know where all the public restrooms at the stores, parks, museums, concert halls, etc. are because I always need one when I leave home. It's hard to imagine that problem being exacerbated. Until April, my nephrologist limited liquid intake (I only drink water and iced tea) to 30 oz a day. I have only recently been permitted, with a spate of hotter than usual weather this summer), increased that to make sure I am not thirsty.

I have not started Jardiance (with the "permission" of my local nephrologist) because my son and his family had planned a week long trip to visit us. They live 3 hours away by plane. Their youngest has never been to visit us and the older one was 18 months old when she was here. She asked to come to MN. I wanted to be able to participate in the outings (parks, zoos, etc.) with them. They left us two weeks ago. My local nephrologist said I could skip Jardiance when I wanted to but it didn't make sense to me to be starting new med with an on again/off again dosing schedule so I am waiting to revisit this topic with the Mayo doctor this week.

I am hoping to learn of others experience with Jardiance, especially wrt the two common side effects.

Thanks in advance.

Hi, I have been on Jardiance 25 for a little over two years now. The main thing I've learned is to drink a lot of water to help clear it from the kidneys. Thankfully my ckd 3b seems to have slowed way down in the progression and I'm attributing this to both the Jardiance and the Renal Diet. It does lower glucose levels also so be careful if you are diabetic and take anything else to help manage it. I'm also currently on Mounjaro and go hypoglycemic easily since being on both. Let us know how you are doing.

Hi,

I’m curious about anyone’s experience with Farxiga vs. Jardiance. Besides the financial difference, is one better than the other for CKD3. I’ve been researching as much as possible and it seems like Farxiga is the one I should use. No opinion from my Nephrologist really. Any thoughts or experiences would be helpful. Thanks.

@gingerr Since I posted in this thread, my swelling got noticibly worse and Farxiga was added to my formulary so, because both of my nephrologists (HMO and Mayo) recommended it, I gave it a try. After a few days, my BP (normally ca. 125/67) was 145/75 so I stopped taking it. My doctors did not comment on the BP rise. I couldn't think of any other changes in my life that could have caused it.

After a few weeks, I started Jardiance. As I wrote earlier, I was pretty nervous about the side effects. Since I haven't experienced any side effects, I am still taking it. My swelling is down--I think a lost about four pounds (of water?). In the morning, my ankles look like a teenager's. They're also much thinner than they used to be at bedtime.

I take it at breakfast (with a slew of supplements to replace minerals that have gone missing from meals because of other dietary restrictions). I have noticed that trips to the bathroom are up in the morning and gradually decrease in frequency as the day goes by. I didn't feel it necessary to pause Jardiance when we spent five days with the grandkids.

@mnsansei thank you for sharing. I too am concerned about the side effects. I hope Jardiance continues to work for you.

I was put on forxiga to improve my kidneys. After about two weeks I felt awful. Blood test revealed an eGFR of 23. I’d been stable at 30-33 for years. Nephrologist told me stop taking forxiga immediately. She said for some people with CKD it makes things worse. She said that I would probably need to take Jardiance eventually but not now. Final thing she said was that trying to treat lower side eGFR before it is critical can cause more problems. So I am waiting for things to get worse before I take any new treatments.

How much of water do you drink w CKD 3b condition?

Nephrologist tells me that because of Hydro nephews is (water or urine flooded kidneys), my intake of water must be reduced to 32oz per day. This is summer like time.
Very thirsty and I want to drink at least 64 ounces perday.

What do you think?
Please reply. Thanks.
VJ