Category Archives: Hypertension/High Blood Pressure

Dear Doctor, While in the army in 1987 I had 2 Intravenous Pyelogram (IVP) using iodinated contrast dye. These tests were to look for a hematuria in my kidneys. I donated a unit of blood several times each year and in the fall of 1991 I was rejected as a blood donor because of high blood pressure. My height and weight and physical activity has always been good. I was treated for high blood pressure then for many years. I began to loose kidney function and went into End Stage Renal Disease the Summer of 2007. After 6 months of dialysis, I have now had a successful kidney transplant for nearly 11 years. The question I have is: has there ever been a link to IVP and kidney disease with the dyes used back in 1987? I believe the kidney disease caused my high blood pressure. Thank you.

As far as we know, contrast (dye) associated kidney disease is an acute injury and not a progressive chronic injury. Hence, we do not have any research that suggests that remote exposure to contrast is associated with chronic kidney disease … Continue reading

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

Good afternoon Doctor, I am 37 years old and I live in Colombia I have an unspecified chronic kidney damage, I feel very bad since the nephrologist says that if I have a biopsy I can bleed because my kidneys are small, creatinine It is 2.40 I do not have diabetes or suffer from high blood pressure my bones if they hurt me a lot and there are days that I feel very tired I would like to know a treatment and what can I do Doctor please. Thanks from my heart.

If you have none of the usual risk factors for kidney disease, such as high blood pressure, diabetes, family history, or obesity, then a kidney biopsy may be the only way to tell you what your disease may be. In … Continue reading

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

I am 80 years old Asian male. My A1c level in August 2018 was 7.5. However, my creatinine level recently increased to 1.59. I am extremely concerned about it. What can I do to reduce this level? I am currently taking tablets for diabetic, blood pressure and Simvastatin. My lipid results are well controlled (Ch, HDL, LDL, triglyceride- all less than the limits).

You may have chronic kidney disease (CKD), but I am unable to make a specific diagnosis based on the information that you present. Diabetes and high blood pressure are the two most common causes of CKD. In the management of … Continue reading

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

Hi Dr. Spry I am a 65 year old female, with controlled type 2 diabetes, controlled blood pressure, 5’4 tall, weight 210, which I’m actively working on losing. Last week I finally activated our hospital patient portal and started to go through my information that was there. I was stunned to read in diagnoses from November of 2017, that it said I had chronic kidney disease with controlled diabetes mellitus, and chronic renal failure stage 2, mild. My eGFR at that time was 57. My creatinine was 1.03, and all other tests for kidneys were a few points into the abnormal range. The doctor never told us this diagnoses, and now, 10 months later I find out this way. I immediately did research to see what I could do to slow down the progress, where I discovered that an eGFR of 57 is 3’rd stage, not 2’nd. These unacceptable issues will be discussed with him at the only available appt they could offer for follow-up, which is October 5, 18. In the meantime I am making an appt with a kidney specialist, and I also started a renal diet 3 days ago. I started a daily exercise program. I have increased water intake, stopped coffee and diet soda. What else can I do to help myself, and based on the lab values I mentioned, how serious is this? I am also confused by the 2 diagnoses. As I don’t know a lot about kidney disease, how could I have both? I thought renal disease and kidney disease were one and the same. Thank you for reading my “book” and any light you may be able to shed on this situation.

Chronic kidney disease (CKD) and chronic renal disease are the same thing. We prefer the term “chronic kidney disease” rather than the latter term. Diabetes and hypertension are the two most common causes of CKD. Stage 2 CKD means that … Continue reading

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

I am a 71 year old female who found out a few years back that I have an artery to one of my kidneys that has stenosis, recently I had a GFR which came back at 55 which is not terrible but Dr. is watchful, I am having a Doppler of my kidneys soon. My blood pressure yesterday was 120/72 which is controlled by blood pressure med and my cholesterol triglycerides were slightly elevated otherwise within normal limits again controlled by a statin. I am trying to loose weight and am exercising daily. My understanding is that this is a progressive situation and being a former nurse I know where that can lead, what can I do to delay the progress as long as I can? Also what do you think about balloons or stents should it come to that? Thank you.

The medical treatment of kidney artery stenosis (blockage) is to keep the total cholesterol under 200 milligrams per deciliter and the LDL (Bad) cholesterol under 100 milligrams per deciliter using a statin anti-cholesterol drug. Your blood pressure should remain controlled … Continue reading

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

My son is 10 and his blood pressure averages 80/60 but also spikes to 200/186- he is on a Clonidine patch to keep the highs not so high (130/121) and we do two IV’s of saline to keep the lows (which have been as low as 50/30) up and has very narrow pulse pressure. (Dysautonomia) Ultra sound said “Elevated aortic peak systolic velocity, often seen in the setting of hypertension.” (214 cm/sec) but no stenosis evidence and normal appearance. Urine testing showed PROTEIN CONC URINE 24 mg/dL PROTEIN/CREATININE RATIO 0.17 mg/mg =1.030 1.005 – 1.030 PROTEIN (UA DIP), POC Negative mg/dL Only abnormal blood is CHLORIDE and Lymphocytes. Are these numbers concerning or normal?

I am not able to make a specific diagnosis based on the information that you provide. The elevated peak velocity in the aorta that you describe is likely on the basis of the dysautonomia that is present in your son. … Continue reading

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

I am 82 years old retired from active service. I am operated for Thyrodectomy in 2002, Bypass surgery( CABG ) 2006 ; Pace maker in (2015) ; & stent in September 2017. I have been BP patient for 30 years & Diabetes for 12 years ( both under control ). Presently I am on light medication for both BP =140/70 & Diabetics = 110/155. After stent insertion in 2017, I was administered Telmisartan 20 1-0-1. There after my serum creatinine steadily climbed up up to 1.5. Kidney – For the last one year, my Serum Creatinine has steeply gone up from 1.2 to present 1.5 mg/dl. Generally, some edema is seen on foot only. I am on following medication: -Plavix75 1-0-1; Rosuva F 10; Telmisartan 20 1-0-1; Ecosprin 75 Linagliptin 5; Glimapiride 1mg; Metformin 500 0-1-1; Urimax 0.4; Calcium 250; and Thyroxin100mcg. Diet: I am vegetarian, I ensure leaching of vegetables for low potassium & phosphorous intake. Have reduced salt. Protein 250 gms, Potassium – 2300 mgs, Phosphorus – 750 mgs, Salt – 2300 mgs. For my present serum creatinine to go up, — Telmisartan & Metformin medication are the affecting factors besides longstanding diabetics & BP. I would be grateful for your advice, for reducing my serum creatinine & hold my DKD/CKD at satisfactory level.

From your review, I believe that you are well managed and would have no suggestions. Your protein intake may be a little excessive, but I do not know your body weight. I generally recommend protein intake of between 0.8 and … Continue reading

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

Hello Doctor, I am age 39 years. I am living in Denmark from May 2015 but I am originally from India. My urine report says that I have protein in my urine. I have undergone 4 tests from May 2018 onwards till now. My father was having kidney disease and high blood pressure and he died to kidney failure at age of 78. My elder brother is of 49 years and both of his kidneys have failed and he is on dialysis from December 2016 onwards. This is the reason I am worried. I read on internet and found that protein in urine because kidney is unable to filter it out from blood. If protein in urine comes for 4 consecutive times at interval of each month, it means there is some problem with kidney. I also suffer from high blood pressure and I take following medicine every day once: 1. Tolura 80 mg (Telmisartan) 2. Simvastatin 40 mg. I was taking above medicine as advised by Indian doctor from 2013 onwards and doctor in Denmark continue the same medicine. Doctor in Denmark increased the dosage of Tolura from 40 to 80 from June 2018 onwards and told me that it will help kidney to work fine. I had a blood and Urine test today i.e. 15.08.2018. The report says that protein level have been increase from last time so increasing dosage from 40 to 80 mg is not helping. I believe there is something wrong with my kidney. I talked to my doctor here and they said that if protein level is 750 or above or it increase by 5 every year than I should see the kidney specialist. I think they are waiting to happen something and then they will start the treatment. I feel prevention is better rather than waiting to fail. My own or regular doctor is a general physician. Can you please suggest what should I do? How to find the actual cause of protein in urine? Which test can find it out? I have attached the blood and Urine report here. The reports are as per Danish laboratory standard but it is understandable.

I am unable to accept any records or attached reports. The treatment of low levels of protein in the urine is to control blood pressure and use agents that are either ACE-inhibitors or ARB agents. The Telmisartan that you are … Continue reading

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

Doctor, my wife is diagnosed with IgA +3 Disease and advised to take steroids. Her current B/P is 140/90 and proteinuria 4+. Please advise whether steroids are must to take or we can go for alternative medicines?

The use of blood pressure agents such as ACE-inhibitors and ARB agents are most commonly recommeded in patients with Immunoglobuliln A (IgA) nephropathy. Corticosteroids, such as Prednisone or Dexamethasone are also commonly used depending on characteristics found on the kidney … Continue reading

Posted in Ask the Doctor, Hypertension/High Blood Pressure, IgA Nephropathy/IgA Dominant Glomerulonephritis, Kidney Biopsy, Kidney-Related Health Questions

My mother has swelling of both legs. The Doctor advised for ACR and blood creatinine and HGBA1C. The test results was: UA/C-1142 microgram, creatinine urine -17.5, blood creatinine 0.9 & HgbA1c-6.7 and B.P 140/80. Doctor prescribed TELSAR 80, ONDERO-5, DYTOR-5. After 3 months, all the test done again and the result are UA/C-2000, creatinine-urine-10, blood creatinine-1 & HgbA1c-5.8. The result very much frustrated but the swelling is much better than before. What do I have to do now?

The desired effects of the medications have occurred. If your mother’s blood pressure is less than 130/80 and her diabetes has been under good control as judged by her improved HgbA1c, and her swelling has improved, then I would say … Continue reading

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