Category Archives: Hypertension/High Blood Pressure

I am a PKD stage 3 patient and my GFR is 37. Could you please suggest the best medication for my BP? I am taking Lotrel at this moment and I feel tired. Thank You.

I am not able to recommend medical therapy without performing a complete history and physical examination.  Lotrel (Benazepril and Amlodipine) is a common combination medication used for blood pressure control.  I suggest you review your concerns with your primary care … Continue reading

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

Good Day Dr. I am 76 year old Male white. Since I am 40 years old, I check yearly. The last lab show a slight rise in Creatinine 1.18 with GFR of 60 (MDRD) and I have Hypertension but under control. My fasting blood sugar 101, no Protein in the Urine. What your advice to me? Dr. Thank you.

I am unable to make a specific diagnosis based on the information that you present.  I am not sure if you have chronic kidney disease (CKD).  It is important that your blood pressure be controlled to less than 130/80.  You … Continue reading

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

I have stage 3 CKD (Creatinine 1.6 – 1.8) but keeping blood pressure down has been difficult. First of all, recent ultrasound shows Left Renal Artery blood flow is very good, left Kidney is 11 Cm size. Right renal artery plugged and dried up since April 2016. Right kidney now still operating from 2 small arteries and Vascular surgeons opinion is doing maybe 5% of load. It has reduced in size to 5.1 Cm. Question is: How much effect does atrophy hormone have in keeping blood pressure higher. And how long should it take for right kidney to atrophy down to it’s ultimate size as determined by blood supply to it. Average daily pressure is 140 / 80 with pulse about 60 -70. I am taking 100 Mg Metoprolol, 12.5 mg HCTZ, 2MG Doxazosin, and 12.5 mg Spironolactone (1/2 – 25 mg pill) Any medication changes suggested?

The small right kidney can certainly make blood pressure more difficult to control. The kidney that is getting very little blood flow produces a hormone called “renin” that causes the blood pressure to be higher and can injure your remaining … Continue reading

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

Does drinking energy drinks put you at risk for kidney failure?

Energy drinks generally have large amounts of sugar and caffeine and may lead to weight gain and an elevated blood pressure. I suggest that you review your intake with your primary care physician (PCP) and see whether this is a … Continue reading

Posted in Ask the Doctor, Hypertension/High Blood Pressure

I have secondary FSGS stage 3. Is the ketogenic diet safe for me? I’ve been eating keto for months and feel amazing. I have lost 30lbs and have been able to drop one of my BP meds and my cholesterol meds. Some say keto is bad for the kidneys, are you familiar with this way of eating? I have little to no carbs each day.

The Ketogenic diet has been shown to promote weight loss and may be helpful in lowering your blood pressure. In some cases the Ketogenic diet may lead to malnutrition and this may have to be monitored. If you are eating … Continue reading

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

Over the last three months I have seen my creatinine levels increase and Gfr decrease. I raised my concern to my urologist. He said I should not be concerned but ordered a renal ultrasound. He added that if something was found he would refer me to a kidney expert. The ultrasound results indicated normal, no abnormalities. I discussed results with my urologist and he said there was no need for concern and he would see me in six months. I have no symptoms (ankle swelling etc.) However, I have read that in most cases of kidney problems there are no symptoms. One symptom is bubbly urine. I do not want to wait until it’s too late. Current creatinine level is 1.44 and Gfr is 52. I am 83 years old.

I recommend that you have urine testing for blood, protein and infection. If these results are abnormal, then consulting with your primary care physician (PCP) or a nephrologist may be indicated. The estimated glomerular filtration rate (eGFR) that you quote … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Nephrologist

Hi Doctor, I know you answered this question already. That CKD is not reversible. I understand that it is generally irreversible when the damage is too extensive, i.e., later stages of CKD. However, at early stages, the damage is not widespread. If the kidney function is still normal and proteinuria is in remission, why is it impossible to reverse the damage? There is evidence that hardening of the artery walls in heart disease patients can be reversed when the patients are put on a healthy diet. If proteinuria is gone and a healthy diet is adopted, there is no more injury to the kidney. Why then damaged nephrons (just a bunch of blood vessels) can not be repaired or reversed in the same way heart arteries can be repaired? What makes our kidneys so special?

Once the small filters of the kidney (glomeruli) and tubules (nephrons) of the kidney have been destroyed, the kidney has no capacity to replace those destroyed glomeruli and nephrons.  It is true that the glomeruli are blood vessels but they … Continue reading

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

I am an Indian. My father has CKD. His present serum creatinine is 1.73 & ACR is 135. His blood pressure 120/80, fbs- 95 & pp- 320. Presently I am in touch with a reputed nephrologist. According to my doctor there is no medication for CKD. He said we only have to control blood sugar & pressure. Please give me your valuable opinion to improve my father’s health.

For patients with  chronic kidney disease (CKD) related to high blood pressure and diabetes, the treatment is to carefully control both diseases. Hence, your doctor is correct. It is important that your father not smoke, limit consumption of alcohol, exercise … Continue reading

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

Dear Dr. Spry: I understand that the DASH diet is recommended for those with kidney disease. However, I’m perplexed by the recommendation in the DASH diet that people consume up to 6 servings of meats, poultry, and fish per day (see https://www.nhlbi.nih.gov/health-topics/dash-eating-plan), as my understanding from the scientific literature is that daily protein consumption (particularly from animal sources) should be limited to no more than 0.5 g/kg of body weight, for people with kidney disease. Under the DASH diet, 6 daily servings (even small servings) of animal-source protein would greatly exceed the quota, would it not? (See, for example, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406621/). Thank you.

I do not recommend very low protein diets for patients with chronic kidney disease (CKD). In the largest prospective controlled trial of low protein diets in patients with moderate to severe CKD, the study did not show a benefit and … Continue reading

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

64 y/o male with GFR fluctuating from 55-72; no other symptoms except HBP which was recently diagnosed and put on meds approximately 3 weeks ago. BP been good since. No other symptoms except possibly slight foamy urine on occasion. Is this a reason for concern for kidney problems?

High blood pressure is one of the leading causes of chronic kidney disease (CKD). Hence, there is a concern for CKD in all patients with high blood pressure. Your blood pressure should be controlled to less than 130/80 and you … Continue reading

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