I have had several blood tests dating back to March of 2017. The tests all show creatinine levels of 1.3 to 1.6 and eGFR of 44 to 55. My family doctor says I don’t need to do anything unless eGFR drops below 30, but my research indicates I should be doing something now. Also, I am on hydrochlorothiazide for high blood pressure and I am wondering if kidney disease could be causing high blood pressure?

High blood pressure and kidney disease are similar to the conundrum of chicken and the egg.  High blood pressure can cause chronic kidney disease (CKD) and CKD can also cause high blood pressure.

Hence, the goal of treating high blood pressure is to achieve 130/80 or less.  You should follow a low salt diet such as the DASH diet.  You can review the DASH diet at:  https://www.nhlbi.nih.gov/health-topics/dash-eating-plan

You should not smoke.  You should exercise regularly and maintain a healthy body weight.  You should avoid non-steroidal anti-inflammatory drugs (NSAID’s) such as Motrin, Ibuprofen, Advil, Aleve and Naproxen.  You should have regular testing of your kidney function with urine and blood and see your physician regularly.  In most cases, primary care physicians (PCP) are very competent in the care of CKD.  I generally advocate for seeing a nephrologist if your estimated glomerular filtration rate (eGFR) is less than 30 milliliters per minute per 1.73 meters squared.  Your PCP may refer earlier than this if he or she is concerned about the specific diagnosis or needs help with management.


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