Kidney Transplant Medications: Using ramipril to control protein in urine

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Kidney Transplant Medications: Using Ramipril to Control Protein in Urine


Guest: Don Holzheimer – Kidney Transplant Recipient

Host: Dr. Linda Austin – Psychiatry, MUSC

Dr. Linda Austin: Don Holzheimer is a participant in a very interesting research project here, at MUSC. Don, you actually received a kidney transplant, what, three years ago? Is that right?

Don Holzheimer: It was actually two years ago: September 17, 2007.

Dr. Linda Austin: And, I understand that was a transplant from your brother?

Don Holzheimer: Correct.

Dr. Linda Austin: How long were you ill with kidney disease before the transplant?

Don Holzheimer: Actually, I was probably ill for several months before I was diagnosed. I showed some subtle symptoms of kidney failure, but I hadn’t actually known until I saw my doctor. He drew blood, and then we saw the lab results. There was a clear indication that I was suffering from end-stage renal disease. And shortly thereafter, I started dialysis.

Dr. Linda Austin: How old were you at that time?

Don Holzheimer: I was 41.

Dr. Linda Austin: Boy, that must have been a shock to you, I would imagine. Or, had you had other illnesses leading up to that? What caused your kidney failure?

Don Holzheimer: That’s a very good question. The first signs of my kidney failure occurred in 1988. I was actually diagnosed with proteinuria, which is an overabundance of protein in the urine. And, being as young as I was then, I didn’t take it too seriously. And, then, several years later, I had to start seeing a nephrologist; a specialist, so they could monitor the functioning of my kidneys.

In 1992, I was told that, eventually, I would be going down the path where my kidneys would stop working.

Dr. Linda Austin: I see.

Don Holzheimer: So, I was diagnosed with chronic renal failure in 1992.

Dr. Linda Austin: I see. So, it really had been a long time evolving?

Don Holzheimer: Correct.

Dr. Linda Austin: So, you must have been thrilled, and very grateful, to your brother for stepping forward and sharing a kidney with you.

Don Holzheimer: Absolutely.

Dr. Linda Austin: That was quite an act of love. Now, let’s talk about this particular study that you’re participating in. What is the goal of the study? What are they trying to learn?

Don Holzheimer: One of the medications that I’m taking in the study is only indicated for the control of blood pressure; high blood pressure. They want to determine if it can actually control the amount of protein that gets excreted in your urine; to try to decrease that amount. They’re also trying to pair that up to change my immunosuppressant medications, to see if there can be a better balance in terms of their effects.

Dr. Linda Austin: How long have you been on this medication now?

Don Holzheimer: Actually, it’s been about 52 weeks.

Dr. Linda Austin: Oh! Wow! So, you have a one-year anniversary.

Don Holzheimer: Pretty close. I think the study’s actually going to be coming to a close pretty soon. The study lasts 60 to 84 weeks. But I believe, just the way my body has responded to the study, I may only have one more appointment.

Dr. Linda Austin: Have you done well on the medicine?

Don Holzheimer: Actually, I’ve done spectacularly. I think my doctor is actually going to keep me on the current medication regimen, because my body has responded so favorably.

Dr. Linda Austin: That often happens with our research, clinical trial protocols, that you get a medication; that may be unavailable to other people, on an experimental basis, and then if you do well, you get to stay on the medication. So, it sounds like that’s been your situation.

Don Holzheimer: Yeah. I’ve been doing very well in the study.

Dr. Linda Austin: Have you ever participated in a clinical trial before.

Don Holzheimer: Actually, no. This is my first one.

Dr. Linda Austin: Really?

Don Holzheimer: Mm-hmm.

Dr. Linda Austin: Tell us about the experience. Somebody listening to this podcast will be wondering: what’s it like; should I participate in a clinical trial? What would you tell them about the experience?

Don Holzheimer: Well, I would tell them that the doctors have your best interest at heart. In this study, I was seeing the doctor at least weekly in the beginning to make sure that there weren’t any adverse effects to the new medication regimen, as far as my kidney function, and any other things that can happen. Early on, I actually developed a small rash, because I was dosed too high. So, they regulated my dose, and that was resolved. They’re really good about making sure that you’re going down the right path; especially someone in my condition. I have a very suppressed immune system, and the goal is to not affect the new transplanted kidney, and to see if a better balance can be achieved in terms of my medication regimen; to see if there might be other alternatives. So, yeah, it’s perfectly safe. There’s a lot of follow-up.

Dr. Linda Austin: Yeah. I think that’s pretty typical with new medications, or a new indication for an already approved medication. You get followed every single week, so if there’s any kind of change, the physicians can react very quickly. People actually get the gold standard of care when they participate.

Don Holzheimer: Absolutely.

Dr. Linda Austin: Well, you may know that we’re embarking on a heroes campaign, to celebrate people like you, who have participated in clinical trials, and to encourage other people to do likewise. As you know, the progress of science depends not only on the hard work of the doctors and scientists, and nurses, but also on people like yourself, who are willing to step forward and dedicate your time; take a little bit of a chance, and commit to helping to see if there are new treatments available. Without this, medicine would stand still, where it is right now.

Don Holzheimer: Yeah. That’s absolutely true. Usually, when they do the initial tests on any kind of medication, they use laboratory animals, but you don’t really know what the effect is going to be on humans unless people participate.

Dr. Linda Austin: Right. And, some of what they do is try to figure out the dosing schedule, see if there are side effects; obviously, figure out if it’s going to help. But it sounds like all of those things were really positive for you.

Don Holzheimer: Correct.

Dr. Linda Austin: Well, you have the biggest smile. You really light up the room. You have a great attitude about all of this. And we’re so grateful to you for participating in the trial, and for telling your story today.

Don Holzheimer: Well, thank you very much. I appreciate it.

Dr. Linda Austin: Thanks for stopping by.

If you have any questions about the services or programs offered at the Medical University of South Carolina, or if you’d like to schedule an appointment with one of our physicians, please call MUSC Health Connection at: (843) 792-1414.

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