I am 64 years old with hypertension. To treat my hypertension, my doctor put me on an ARB, Losartan. Prior to this, my urine and blood work was normal. My GFR was in the 58-64 range. After being on the ARB, my GFR is now in the 53-58 range, putting me at stage 3A of CKD. My doctor mentioned that it is normal for creatinine to rise up to 20-30% when you are taking an ARB or ACEi leading to a reduction in GFR but I do not have CKD as my urine and other blood work is in normal ranges. My blood pressure is now in a normal range 115-75. Did I just eliminate my hypertension but got CKD to replace it? This has me really worried.

It is true that the treatment of high blood pressure using an Angiotensin Receptor Blocker (ARB agent) or an Angiotensin Converting Enzyme Inhibitor (ACE-I) will result in a slight decrease in the estimated glomerular filtration rate (eGFR). High blood pressure is the most common cause of chronic kidney disease (CKD). However, with continued treatment, this will prevent further deterioration in the eGFR. The high blood pressure (hypertension) that you have, was injuring the kidney and resulting in excess pressure in the kidney filters (glomeruli) and this leads to a higher eGFR by the kidney but at the expense of kidney damage. As you now treat the hypertension, the eGFR falls slightly but stabilizes over time to prevent ongoing deterioration of your kidney. I agree with your doctor that this is appropriate treatment and recommend continued monitoring of your kidney function.

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