Category Archives: Hypertension/High Blood Pressure

my question is about my stage 4 chronic kidney disease, doctor when I breathe I feel a strong pain in the under the lungs is how a very hard squeeze. Doctor I do not have fluid retention, I do not have hypertension the pth is in 263.90 with very small kidneys less than half of the normal of an adult, I am not on dialysis or pre-dialysis what can I test can you recommend to see what is affecting my Kidneys, my nephrologist does not recommend a biopsy because the kidneys are very small and can bleed. I don’t know what is causing my kidney disease. Can you give me a concept Doctor a hug and blessings.

I am not able to make a specific diagnosis based on the information that you present.  Your symptoms could be consistent with chronic kidney disease (CKD) but you indicate that you do not have fluid overload.  Your blood pressure should … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

How does alcohol effect CKD?

Excessive use of alcohol can lead to liver damage that can cause worsening kidney disease. Alcohol in excess also causes worsening of high blood pressure and can lead to an acceleration of kidney disease. Excessive alcohol is more than two … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Risk factors

What are your thoughts on using canagliflozin for those with increased albuminuria?

Canagliflozin (Invokana) and Empagliflozin (Jardiance) are Sodium/Glucose cotransporter 2 inhibitors (SGLT2 inhibitors).  They are used to treat Type 2 diabetes and they cause the kidney to eliminate glucose in the urine.  This can lead to weight loss and also can … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Microalbuminuria

My boyfriend is 44 yrs old has gout,type 2 diabetes, reduced kidney function, hx of kidney stones and hypertension.They have referred him to a nephrologist and rheumatologist and podiatrist.Which specialist would be the best to be able to get the optimal treatment? I read an article on this site referring to that suboptimal care given to patient with gout and ckd.

I believe that a nephrologist should be able to address most of the issues that you mention.  A rheumatologist could address the issue of gout and I’m not sure what a podiatrist might be able to offer.  All of the … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Gout, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Nephrologist, Treatments

Our 30 year old daughter had a bone marrow transplant a year ago. The main medicine was tacrolimus. Tacro made her kidneys “angry” and she went on a low potassium diet, and drank lots of water. She was monitored and kept her “number” down. Now that she has been off Tacro since August, she feels like her kidneys are not “quite right”. (her words). When she gets up in the morning, she can feel them – a funny feeling. She also continues to drink 100 oz water a day. She feels she cannot exercise as she wants because she gets dehydrated. So, my question is: will this go away? Will she always struggle with kidney issues? Do kidneys repair and return to normal after tacrolimus? Thank you.

I am not able to make a specific diagnosis of chronic kidney disease (CKD) based on the information that you present.  It is true that Tacrolimus can cause injury to kidney function and result in high blood pressure as well … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Symptoms and Side Effects

I’m a 74 yr old white woman. On 6-9-19 my gfr was 60. In late June I started taking Hyzaar. The gfr declined to 55 on 7-11. The Hyzaar was increased in mid-July. The gfr declined to 52 on 7-29. The gfr declined to 49 on 10-30. The doctor says this is stable. I don’t understand how an 11 point decline in gfr is considered stable. Could you help me understand this? Should I stop taking Hyzaar?

 High blood pressure is injurious to the kidney.  Hence, if your blood pressure was greater than 130/80, then your estimated glomerular filtration rate might be higher as a result of the high pressures but over the course of time, progressive … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Medication and Kidney Function

Hello, My doctor is telling me I don’t have anything to worry about, but I would like to see what you think. My doctor says there is no worry about these numbers because “the existing controversy of using only eGFR and Creatinine levels as markers for staging of CKD and that without evidence of protein, blood or possibly glucose in his urine that attempting to stage CKD is futile.” I am very worried. I am a 50 Year old white male currently stationed at Fort Leavenworth, Kansas. I take 10 Mg of Lisinopril for High Blood pressure (started March 2019) and 10mg of Lipitor for cholesterol (started September 2019), height 5’9″, weight 178lbs. I have never had any health problems before this year. My current lab tests results are below.C-Reactive Protein <0.20 GFR Stats for past 2 years. March 2017 = 68.8 May 2019 = 67.18 September 2019 = 66.0713 October 2019 = 55.7528 (10.3185 point drop from previous month) He told me about the existing controversy of using only eGFR and Creatinine levels as markers for staging of CKD and that without evidence of protein, blood or possibly glucose in his urine that attempting to stage CKD is futile. Urinalysis Results – October 2019 "Urinalysis W/Reflex Microscopic+Culture" Test Name Appearance – Clear Albumin – 4.5 Bilirubin – Negative Blood – Negative Color – Yellow Glucose – Negative Ketones – Negative Leukocyte Esterase – Negative Nitrite – Negative pH – 5.5 Potassium – 4.4 Protein – Negative Specific Gravity – 1.01 Urobilinogen – 0.2 Chem 14 w/eGFR (Plasma) Results – October 2019 Albumin – 4.5 Bilirubin -1.0 Calcium – 9.3 Carbon Dioxide – 24.3 Chloride – 104 Creatinine 1.45 Higher Than Normal Glucose 99.0 Alkaline Phosphatase 92 Potassium 4.4 Protein – 8.60 Higher Than Normal Sodium 139 Alanine Aminotransferase 28 Aspartate Aminotransferase 17 Urea Nitrogen 17 GFR Non-Black 55.7528 Lower Than Normal Please let let me know what I can do if anything. Thanks

High blood pressure is among the most common causes of chronic kidney disease (CKD).  The single test that you mention with an estimated glomerular filtration rate (eGFR) of 55.7 milliliters per minute per 1.73 meters squared seems to be an … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Treatments

I am 65 years old male with stage 3a CKD. All of my blood and urine work is in normal ranges but my eGFR is 50-53 and creatinine is 126. I have blood pressure well controlled with Losartan and Norvasc 110-115/ 75. I follow a DASH type diet. A nephrologist consult, which I asked my PCP for, said my numbers are all normal and did not recommend any dietary modifications other than healthy eating habits and that I could do some research on a lower protein diet if I wanted to. I am fearful of developing MBD. My serum phosphorus is 1.4 mmol/l, the lab range is .8-1.5. My calcium is 2.34 mmol/l, the lab range is 2.1-2.6. My PTH intact is 6.5 pmol/l, the lab range is <7. The consult review letter from the nephrologist to my doctor said I was extremely healthy. I find this comment puzzling given that my eGFR is less than 60. She also had me do a 24 hour creatinine clearance which showed a calculated GFR of 67. I don’t know who or what to believe anymore I am so confused. Should I be following a low protein, low phosphorus diet? Am I in danger of progressing to MBD? I am very scared.

The situation that you describe is very early Stage 3a chronic kidney disease (CKD).  If no other causes were found with your nephrology consultation, it is likely that you have CKD related to your high blood pressure and with your … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Nephrologist

I’m a SLE patient. I’ve been having trouble with edema (especially in my legs), high blood pressure, and weight gain. My gfr was 70 in March it dropped to 55 in August. My creatinine was 1.1 in March. Should I be concerned about nephritis?

Patients with systemic lupus erythematosus (SLE) can get lupus nephritis and should be monitored for kidney disease.  I would recommend that you have both blood and urine testing for kidney disease.  I recommend that you review this with your physician

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Lupus

Recently I went into Stage 4 of kidney disease.  My GFR is 17 and creatinine was 3.66.   I do have high blood pressure but is pretty good with meds (140/80)…also diabetic with an avg reading of 139.  I really am watching my sodium intake and potassium (levels were good with last blood tests).  Old remedy I am told is vinegar with the mother (1 tsp per day with glass of water).  What are you thoughts or experience with this old remedy?   I do drink a lot of water to keep hydrated and flush the kidneys.

I have had many patients mention this to me.  I have never seen any study that suggest that vinegar is of benefit in patients with chronic kidney disease (CKD).  I have not observed any ill effects and I have not … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Treatments