Treatment Choices in Rheumatoid Arthritis – not much choice at all


I saw my Rheumatologist last week.  As is so often the case, I was having a really good day.  I had actually had a couple of good days.  My blood tests told a different story, however.  Not just in their inflammation markers, these quite often don’t correspond to how I’m feeling.  No, this time it was my kidney function.

Because Rheumatoid Arthritis is a systemic disease, it is not just the joints that are affected.  The heart and lungs are commonly involved, and sometimes, the kidneys. More commonly, however, it is the medications used to treat RA that damage the kidneys.  NSAIDs (ibuprofen, naprosyn, etc) are processed by the kidneys, and long term use, or high dosages can cause kidney disease or even kidney failure.

People who have underlying kidney disease need to be monitored carefully, with blood tests.

My kidney function tends to go up and down from time to time.  It has gotten bad enough to be classified as ‘kidney disease’ but not even close to kidney failure.

But now I need to lower my dose of naprosyn, because it is hard on the kidneys.  I take 1500mg daily, which is 1.5 times the max dose.  That’s what I need to function.  My rheumy also said that it’s only a matter of time before I get an ulcer at this dose, even with a proton pump inhibitor.

So I lowered my dose a week ago.

And now I can’t move.  I can’t walk more than a few metres, I am exhausted and every joint is on fire.  I am struggling to type this.

So I have to choose between being able to move, or frying my kidneys.  That’s not really a choice at all, though, is it?

Options?  Go back on prednisone.  Which has its own problems,  its own set of difficult choices.  But that’s another post.


  1. Doesn’t it just figure? What does cure you(I use that term loosely) can kill you. Once you finally are able to find something that makes you feel a bit more “normal”, at least able to live with less pain, you are unable to take it for any extended periods because of the other problems they create. It’s really unreal what having this disease can do to a person. You’ll be in my thoughts and prayers.

    • Thanks Claudia. At this stage of the game it seems its always about choosing the lesser of evils…all the good options were off the table a long time ago. So many of us in the same boat…while the drug company PR is ‘just take this pill and everything will be shiney again’. Sadly no. Not for most of us. Thanks for commenting.

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