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Category Archives: Hypertension/High Blood Pressure
Have three queries for transplant patients 1. When bp is never constant and it goes up when one goes for morning walk or for that matter any physical movement results in bp number. If this is true then why patients are advised to keep blood pressure within a range of 120 to130/80 to 90. Is there any range for max and min after physical exercise. How much mental anxiety or stress impacts BP? 2. Cholesterol reducing medicine mostly statin is prescribed for the patients. Does intake of this medicine for long period of time affect the kidney? 3. Should patients plan volume and timing for this water intake for the day? Thanks doc as always.
The standard way to take blood pressure is to take the blood pressure sitting for 5 minutes. Exercise and physical activity increase the blood pressure and this is normal. The normal blood pressures that you quote are for 5 minutes … Continue reading →
Nutrition treatment is very much dependent on the Stage of chronic kidney disease (CKD) and also on the blood chemistries that are present. Hence, there is no single diet that is suitable for all patients with CKD. I suggest that … Continue reading →
What is my brothers prognosis? He is 59 yrs old, has Type 2 diabetes, kidney failure, on dialysis 3x/wk, cardiovascular disease, peripheral neuropathy, high blood pressure, vision loss, confusion, above the knee amputation, addiction to marijuana, very moody, angry, and nasty. Does not watch his diet or exercise.
I am unable to provide a prognosis without performing a complete history and physical examination. With the information that you present, your brother is very ill. His life expectancy is likely very short. For more information on kidney failure click … Continue reading →
How do you treat CKD patients with atherosclerotic disease of the left common carotid artery? What medications do you give to treat the atherosclerotic disease?
Hardening of the arteries (atherosclerosis) is a disease of blood vessels associated with high blood pressure and elevated blood cholesterol levels. It is also passed down in families and is thought to be related to genetics. The treatment in patients … Continue reading →
I am a 74 year old female and have hypertension and borderline diabetes. My A1C was 6.0 in Nov. 2016. I had a kidney stone and treated with Lithotripsy in May 2016. I made a return visit to my urologist last week with L. flank pain and had a CT Scan done. While the scan did not show a stone on the left side, it did reveal swelling in the tube below my right kidney. My urologist said I should have a procedure done with contrast so he can determine the cause of the swelling. My concern are the risks involved and if its a necessity to have this procedure done? Any idea as to what causes swelling in the tubes? Thank you in advance for your input.
I am unable to make a specific diagnosis based on the information that you present. If your kidney function is otherwise normal, the risk of contrast is very low. I suggest that you follow the advice of your urologist. For … Continue reading →
Hello sir, my mom is suffering from diabetes. Her age is 48. After blood test, I found that her serum urea is 100mg/DL and serum creatinine is 5.74, but the ultrasound report is normal and she has no symptoms. Only blood pressure seems to go up and down. Does medicine help her?
The testing suggests that your mother has advanced kidney disease. I suggest that your mother consult with a nephrologist and have a complete history and physical examination.
My 16 yr old very athletic son suddenly developed HTN 5 weeks ago, along with pulse in 90’s-114 at rest. This was accompanied with intermittent upper mid abdominal pain. After evaluation by a cardiologist, gastro and nephrologist, nothing determined as the cause. His labs showed high Hgb and a 24 hr urine collection showed creatinine of 3402 mg/dl, as well as high norepinephrine and low dopamine. He still has the abdominal pain even though he has been taking a blood pressure med for 3 nights now. He only had 1000ml of urine in 24 hrs (because we had to dump the first specimen) but this does not seem like enough for a 5’11” 180 lbs guy. He does not feel the need to urinate when he wakes up in the morning. I’m scared he has a kidney problem. What tests should be done?
I suggest further testing for an endocrine cause of the hypertension. Your son may need to be seen by an endocrinologist. I would also make sure that he is not taking any body building supplements that might cause these … Continue reading →
My father is a new dialysis patient – only 1 month in. He is 77, diabetic, suffers from peaks of high blood pressure and is now on dialysis. It has been a very hard transition for him to make. His fistula failed so an emergency port was placed in his chest. He has had surgery just this week to implant a fistula graft in his arm. He is currently residing in a rehab facility in a nursing home. I’m sending this because I feel like I cannot get answers from local doctors and treatment facility. This last Monday was the first time his dialysis team was able to get his dialysis up to 400 (Fresenius facility). On Tuesday morning he called me at 6:00am in a panic. He felt like he was having a low blood sugar with sweating and confusion. He was seeing things that weren’t there. His BG was 245 which isn’t that odd for him, so that was ruled out. The nursing home was sure he was going to pass out and were ready to send him to the ER. After he ate and drank something, it started to pass and by evening he was back to his normal self. He was VERY angry at the Monday treatment and so we figured it was a manifestation of his mood. My other instinct is his electrolytes were out of balance. I’ve taken care of my dad for the last four years and in the past when he would get in a similar mood, a gatorade or juice helped ease the confusion. I know gatorade is not good due to the high levels of all the things a dialysis patient shouldn’t have. But he acted like that was what he needed. It got better as the morning went, so everyone moved on. Wednesday night, dialysis again. He was in a much better emotional place than the previous treatment. However, at 4:00am the next morning, he had the same issue. Confusion, seeing things that weren’t there, worry, anxiety. He described it like a nightmare. Then after a meal and a few hours it passed. The nursing home staff have no answers except to refer him for an eval with a psych doctor. We cannot find anything online on any kidney or dialysis sites that relates to dysphoria (nurses said it was a type of dysphoria he was displaying.) The only link to what my dad is experiencing and information is related to dialysis disequilibrium syndrome and all research I’ve found says that is not a common condition anymore with modern treatments. He acts like he’s anemic and his electrolytes are out of balance. We keep getting told that blood tests are done once a month and that would be able to tell us more. The nursing home staff really aren’t doing much to find a solution. The nephrologist NP he sees is out of town till the end of next week. The staff at the dialysis center say its not related. Nothing really online. I’m scared and no one will talk to us about this problem and just want to send us off to someone else. Dialysis wasn’t even on our radar. We knew it might be something in the future but my dads kidney function has maintained for two years between 15 and 20%. No training. No counseling. Nothing. Then he goes to the hospital with what we thought was a heart attack. Very aggressive blood pressure treatment took his kidney function from 14% to 6% in three days. It wasn’t until the third day that his other blood indicators said yes, his kidneys were failing. And, he didn’t have a heart attack. The week leading up to his first treatment, he swore he would not do it no matter the end result. The next morning, he was OK with it, had the emergency port put in and had dialysis three hours later. Now, one month later we are only a little wiser about dialysis and only because we sit with him for each treatment and ask questions of the nurses. Since this dementia behavior has surfaced, we know even less. No one will give us a straight answer, check his blood, do any scans, something…anything that can give us a clear idea of what is going on. My father has a PhD in Mechanical Engineering. My mother was an RN. Four of the eight children and husbands in our family are educators. We are intelligent people seeking intelligent answers. Reaching out to you is a long shot I know, but it is all I know how to do right now. Any advice. Any thoughts. Any history. Any suggestions are greatly appreciated.
Every month, the dialysis team gets together for something called a multidisciplinary conference to discuss the patients in the dialysis unit. I suggest that you talk with the social worker who is responsible for your father and ask to be … Continue reading →
Hi doctor, My husband is suffering from 3rd stage of kidney disease and his creatinine is 1.8 and protein in urine is 2+. We see kidney doctor every 3 moths but they put him on prednisone for one year and now he is taking high cholesterol and high blood pressure medicine. I am so worried for him. I need your suggestions please.
I am unable to make a specific diagnosis based on the information that you present. It might be necessary for your husband to have a kidney biopsy in order to have a specific diagnosis and specific treatment for his chronic … Continue reading →
I was diagnosed with 3rd stage CKD with eGFR of 44.48.49,49. My doctor thinks that my blood pressure medication of Ramipril (10 mg) may have contributed to kidney disease. He has reduced Ramipril to 5 mg and replaced it with 5 mg Amlodipine. As Ramipril is also used in the treatment of kidney disease, should my dosage have been reduced? I have been on Ramipril for more than 10 years.
I cannot offer treatment advice without performing a complete history and physical examination. You are correct that Ramipril (Altace) is used to treat kidney disease, especially in patients who have protein in the urine. I suggest that you discuss your … Continue reading →