Inside Eric Dane's ALS diagnosis and what it could mean for his kidney health

Following Eric Dane’s devastating ALS diagnosis, a board certified doctor detailed to Daily Express US what it might mean for his long-term health.

As fans await word on his return for season 3 of HBO’s Euphoria, Dr. Hofeldt weighed in on how ALS may affect the actor’s ability to work and manage his overall health, including his kidney function.

According to Dr. H, a Yale and Cornell trained physician with over 20 years of experience in internal medicine and nephrology, ALS doesn’t directly damage the kidneys. But, she explained that it can complicate how doctors measure kidney function.

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“Creatinine is a common blood test that checks how well kidneys are working. It’s essentially a waste product of muscles so the lower the muscle mass the lower the creatinine and in general this also means the kidneys are working better,” Dr. H explained.

“In people with ALS, muscles atrophy or waste away, creatinine goes down so less is filtered by the kidneys and looks like kidneys are working better when in fact they may be getting weak.”

Because of that, she says early signs of kidney disease may be missed in people with ALS. “A study shows using a protein called cystatin C that is not impacted by muscle wasting was able to identify a possible link between kidney disease and ALS,” Dr. H detailed.

“They found a higher rate of people with Stage 3 kidney disease where the kidneys are operating at half capacity getting ALS compared with those who have better kidney function.”

When it comes to returning to work, Dr. H says it depends on what kind of symptoms Dane is currently experiencing.

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“ALS is a relentlessly progressive neurological condition…with an average life expectancy of 2 to 5 years from time of diagnosis,” she says. “If he is having difficulty with speech or swallowing, then may be challenging going back to filming compared to mild hand or leg weakness.”

She said that moderate exercise and staying active can be beneficial if done carefully. “So going back to work unless involves overexertion of muscles that could lead to further muscle weakness should not be a concern,” she added.

Muscle loss in ALS does not directly harm the kidneys, but it can interfere with test results. “The Journal of the American Medical Association (JAMA) in a study says that the risk of death and worsening of symptoms is predicted by lower creatinine…due mostly to lack of muscle loss as ALS gets worse,” Dr. H says. “This suggests that maintaining muscle mass and moderate physical activity may be associated with better outcomes.”

She also points out that some medications used in ALS, like muscle relaxants or anti-inflammatories, can affect kidney and bladder function.

“Urinary symptoms may also happen because of other medications like muscle relaxants used to treat muscle stiffness and spasms with ALS that can lead to urine leaking, a strong urge to urinate, and difficulty with emptying the bladder,” she says. “Anti-inflammatory medications like over-the-counter Ibuprofen…should be used in moderation as higher doses may hurt the kidneys especially if combined with other medications.”

As for whether the risk of kidney disease worsens as ALS progresses, Dr. H says: “As far as we know, it does not unless the person has another reason for progression of kidney disease.”

Still, she stresses the importance of checking kidney function routinely in people with ALS, especially since symptoms can be subtle. “Kidney disease can be a ‘silent killer,’ because it does not cause symptoms until later stages so important to be checked regularly,” Dr. H warns.

“Eric Dane is not at higher risk for getting kidney disease by having ALS although the relationship between kidney disease and ALS is not well defined unless he has other common reasons for kidney disease like high blood pressure or diabetes.”

For more information, visit www.askdoctorh.com