Category Archives: Hypertension/High Blood Pressure

I just found out the other day my kidney function is at 40 %. I have high blood pressure controlled by med. My stomach is swollen. What risks am I facing?

High blood pressure and chronic kidney disease (CKD) are usually two diseases that do not have symptoms. The fact that you are having stomach swelling cannot easily be explained by high blood pressure or CKD. I suggest you see your … Continue reading

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

Good Morning Doc, I am a 48 yo white female, I have a congenital solitary, hypertrophic kidney. It has a large renal pelvis and low grade reflux that has, thus far, only given me trouble once. About 10 years ago when I had a bad infection which put me in the hospital with septicemia. Luckily it was an isolated incident. I work in healthcare as a surgical tech so I’ve always remained very conscience of what I take, medication-wise and try not to “tax” my kidney any more than I have to. I’ve experienced left plantar foot radicuopathy for the past year due to a herniated L5-S1 disc and have refused pain meds. I don’t take NSAID’s. I have had 2 epidurals which have given me some temporary relief. But I still have some burning and tingling in my foot that just won’t go away. The doctors want to put me on Cymbalta for nerve pain. Which at this point is considered chronic pain. I classify it as “annoying” and “quality of life” more than pain and am very frustrated so I’m considering it because I don’t believe surgery is necessary at this point. My question is this: What are the long term affects of Cymbalta on the kidney? I can’t find any information, no one has any answers. Are there any studies? How long is “too long” to take a drug like Cymbalta when the kidney is concerned? Also, my plan if I decide to take it, is to have blood tests every 3 months. What do you recommend I test for?

Cymbalta (duloxetine) is Serotonin-Norepinephrine Reuptake inhibitor (SNRI) similar to other antidepressant drugs that are on the market. It has more properties that are pain relieving and has been particularly useful in the treatment of chronic pain. I do not believe … Continue reading

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

How is the frequency of hemodialysis treatments determined? How is the length of these treatment determined?

There are a number of factors that are considered when prescribing dialysis treatments. Early in the story of dialysis it was noted that patients dialyzed once per week and twice per week did not do well. It was not until … Continue reading

Posted in Ask the Doctor, Dialysis, Hypertension/High Blood Pressure, Kidney-Related Health Questions

Hi Dr. My question is should I be consulting a nephrologist at this point or am I getting ahead of myself? I am a 53 year old female. Brief medical history 10 yrs. + metastatic melanoma survivor, one year Interferon. Coronary & Carotid Disease as well as PVD. Type 2 Diabetes but maintain no higher than 6.5 A1c. COPD, pulmonary nodules. Many long term prescriptions, omeprazole, metoprolol, amlodipine, losartan, clopidogrel, rosuvastatin, zetia, metformin and baby asprin. This week I had a urine ACR of 120.4 and it came back from lab flagged as high. For the last few years, my eGFR is 60. My right renal artery also is 50% stenosed. I’ve also been experiencing lower back pain. My question is this: is it too soon to be worrying about my kidney function or are these numbers acceptable? My primary and cardiologist do not seem concerned and in fact wish to increase metformin from 500 to 750. Your opinion would be greatly appreciated regarding my need to see a kidney doctor at this point in time (I’d rather catch anything early than late for a change:) Thank you in advance!

I am unable to make a specific diagnosis based on the information that you present. We do see elevated albumin to creatinine ratios (ACR’s) in patients with heart disease, high blood pressure and diabetes. Any one of these could be … Continue reading

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

What about contraceptive pill? Does this have bad affects on kidney and liver?

Oral contraceptive pills (OCP’s) can cause an elevation of blood pressure, which can complicate chronic kidney disease (CKD). OCP’s can also be associated with blood clotting abnormalities. I am not aware of any liver problems. I suggest you review any … Continue reading

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

My husband hit end stage in August. He is now a PD patient. My concern is that he is still vaping or smoking cigarettes and smokes a lot of weed. His nephrologist said smoking is “out” but it’s worse than ever. What consequences are possible?

Smoking is a risk factor for progression on chronic kidney disease (CKD), high blood pressure and heart disease in addition to lung disease. Many kidney transplant programs do not accept smokers for kidney transplantation until they have quit for at … Continue reading

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

I am a 71 year healthy male with EGFR levels of 57 and 52 for the past year. Levels were in the low 60’s prior few years. Will drinking 3 alcohol drinks per day cause my EGFR level to continue to decline to the point where I would need dialysis or kidney replacement within the next 10-20 years?

I am unable to offer a specific prognosis. I would observe that drinking more than two drinks per day will contribute to higher blood pressure. As your blood pressure becomes higher, this could lead to worsening of your kidney function. … Continue reading

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

I have CKD caused by undiagnosed high blood pressure. My gfr 40 just gone down to 32. Urine test shows protein. What can I do?

You should have careful follow up of your high blood pressure. You have protein in your urine (proteinuria) and this should be treated with an ACE-inhibitor or ARB agent.  Your blood pressure should be less than 130/80. You should follow … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Proteinuria

I am a 60 yo female, normal weight with HTN, well controlled on Lisinopril 5 mg X 2 years. My GFR has been in the low 50’s during that time. I was advised to use Amlodipine for a few weeks, off Lisinopril, then recheck kidney function. I also had a normal U/S and urine test for protein. My GFR returned to >60. But my BP is not well controlled on amlodipine 10 mg. (150/90). Questions:1) Are there permanent possible ill effects of being on Lisinopril and therefore having a lowered GFR, but BP controlled? 2) I know that persistent high BP is damaging to kidneys. Is a good approach to increase my exercise and improve muscle mass (which is decreased) and use the amlodipine and hope to see a lowered BP? Thank you for being a resource to us.

It is often the case that Lisinopril (or any ACE inhibitor or ARB agent) will slightly decrease the estimated glomerular filtration rate (eGFR) and raise the serum creatinine. As the blood pressure lowers with these agents, the eGFR does tend … Continue reading

Posted in Ask the Doctor, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Serum Creatinine

Hello. I have been in recovery for 2 years from substance use (opioids and cocaine). I have a GFR of 72 and it used to be 99, 98. Somewhere in there. My question is, I have gained 70 lbs and am currently 250 lbs. I am 47 years old and I am wondering if there is any way to improve this? I am currently on Norvasc and HCTZ. I am contemplating gastric sleeve surgery. Will this help to improve my GFR? My labs are otherwise excellent. I just want to know about this. Thank you.

Bariatric or weight reduction surgery will not improve kidney function. The goal of treatment for kidney disease is to preserve and maintain kidney function. It is usually not possible to increase kidney function. Treatment of your high blood pressure, eating … Continue reading

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