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British Heart Foundation
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Heart Failure & kidneys

Hi. Just trying to make sense of husbands latest blood test results. Heart failure nurse says she's not worried about the results but to book in for repeat test in 6 weeks. Seemed a bit strange to book in for more tests if the results are good!! However, having got a copy of the results from the Dr the results show serum creatinine level 111, above normal range. serum urea level 8.00, above normal range & eGRF is 61. I know all these refer to the kidneys, should we be worried? particularly as for the first time his ankles are very slightly puffy (probably due to the weather though) Also, due to slightly enlarged prostrate he takes a tablet to stop him going toilet so much in the night, just feeling a bit worried that taking this tablet is masking kidney problems! Any advice would be welcome xx

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Hi lezzers, how long has he been diagnosed and on medication? It's not unusual early on for higher levels to be registering. If not I'd suggest talking to the HF nurse and asking why she doesn't think there is nothing to worry about

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Thank you for your reply. He was diagnosed with HF just over 5 years ago but has had a bad heart since massive heart attack 20 years ago, so he's been on some sort of heart medication since 1998. The last couple of years they've tried him on spironolactone twice but it's affected his potassium levels even on low doseage. The blood tests were to check his potassium had gone down again which it has. However, his creatinine level has been 111 before though this is the first time that I'm aware of that they've tested serum urea. He's not due to hear from his nurse until the next tests are done & cardiologist in November.

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OK, does he see his gp often, is this something you can ask them about? From a very quick look ranges are between 84 and 121 mgs per deciliter

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Thank you, no he doesn't see he's GP often although he will be seeing her in bout a month. He has a cough that he's had for a few years & has always been told its the medication. The cough is getting worse & cardiologist now thinks it might be heart related but wants GP to investigate first. GP is at a loss as to what it is so she's trying him on anti reflux tablets as he's been on aspirin for 20 years. He's been on the tablets just over a month & she wants him to take them for 2 months, so far they're not helping!

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Is he on ramipril? That would cause a cough. If these anti reflux haven't been successful after two months it's time to look at something else

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No he's never taken ramipril, he's on candesartan. He's had a recent x ray on his lungs & that's come back OK, not really sure what more they can do. GP said she was clutching at straws with the anti reflux tablets. We were hoping to book a holiday abroad soon, nurse has said go ahead but I'm concerned that we may miss telling insurers something & they refuse any claim. Unfortunately, he has passed out a couple of times on planes so was thinking of eurostar!! He is a bit of a nightmare!

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Eurostar sounds ideal, you can only tell insurers what he's being treated for, a reputable company will have no issues in covering you.

I would go back to the gp, it clearly isn't reflux. How long has this cough been going on? Could it be seasonal? Pollen count has been exceptionally high this year and for longer periods.

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Thanks for your help. He's had the cough for at least 6 years but it's been slowly getting worse, now it's quite noticeable. They've tried anti histermines, they didn't work. He's had a couple of x rays over this time (last one was a month ago, previous one 2 years ago) as he used to work with asbestos but they're always clear. Plus Dr said if it was anything sinister he would be showing other symptoms now!!! I used to do personal insurance including travel insurance, I'm aware of the pitfalls so it always worry me!

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Hi Im in the same boat..

Hf with Af and stage 3 ckd...for over 2 years now...and still have blood tests every 6 weeks just so they can keep an eye on the results...mine go up down

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Thank you for your reply. Do you know what your levels are?

I don't want to read too much into the results if the nurse is OK with those readings but sometimes the health professionals can be a bit casual bout things. Not that I'm critizing his nurse in anyway, she really lovely & always looks after him.

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Does he take a diuretic ?

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Thanks for your reply, no he doesn't take a diuretic. He did take spironolactone for bout 3 months in 1996 but was taken off it due to high potassium levels. They tried again on lower doseage this year but again potassium went too high after couple of months. That's why he's been having the blood tests, to ensure the potassium level has gone down, which it has.

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Have his blood tests included HbA1c? He may be borderline Type II diabetic (people do not need to be overweight/obese to develop this). Diabetes can affect the kidneys and one of the first signs is adverse creatinine levels.

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Thank you, back in May he had the full works blood tests, including diabetes, thyroid etc. That was all within normal range. When he saw the consultant about a year ago bout his slightly enlarged prostrate he put him on medication to stop him keep going toilet in the night. He also said the kidneys weren't working as best as they could probably because of he's heart failure. Nurse said that was wrong as kidneys are OK, so slightly confused now!!

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Hi Lezzers, I am not sure if this is going to be of help to you but I have heart failure too and take numerous medications. While I was under the care of the Heart Failure nurses a couple of years ago my eGFR dropped to 51 with creatinine at 97 and urea at 10.4 and they weren't at all concerned. When I questioned it I was told my heart was more important than my kidneys and they had patients with GFRs under 30 so my levels were nothing to worry about. My most recent tests showed GFR at 42 and although my GP is going to test it again in a couple of weeks he hasn't advised stopping any of my meds which I am sure are the cause of it dropping. I have recently been started on spironolactone and my potassium levels are rising, but again, not enough to cause concern (5.3 at last blood test).

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Thank you for your reply. Are you no longer under the care of the Heart nurses or a cardiologist? Do you take medication for your kidneys? Finally, the potassium level of 5.3 was the highest they allowed with my husband before they pulled him off the spironolactone.

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I was with the heart nurses for around 18 months while my medication was being adjusted and added to until the correct levels for my condition were reached and then I was discharged into my GP's care. I still see the cardiologist 2-3 times a year and I am actually due to see him this Wednesday. None of the GPs at my local surgery have much of a clue about my medication and a couple of serious errors have been made in the past. My potassium has been at 5.3 on two successive tests over 4 weeks but they want to check it again in another two weeks. I think they are classing it as borderline as the labs they use class 3.5-5.3 as normal range. I haven't been offered any medication or advise for my kidneys and I have a feeling there isn't any meds for CKD although I believe changing diet can help. I don't think your husband has too much to worry about with GFR of 61 but they will want to keep an eye on it to make sure it doesn't drop too drastically.

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Lezzers, you may be interested in the chronic kidney disease chart on Kidney Research UK. There is also a lot of other useful information on there:

kidneyresearchuk.org/health...

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Thank you for the link, I'll try & process it but it refers to urine tests whereas Kevin has only had blood tests

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The chart is mainly for eGFR which is only done through blood tests so the figures will apply to Kevin. You will see that anything over 60% is only mild. My GFR fluctuated between 50 and 60 for a number of years without any problems. The urine test is just an additional test if there is reason to suspect there may be protein or blood in the urine which is not something you should be worrying about at this stage otherwise the doctor would have asked to do one.

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Thank you very much for your advice, I really appreciate it x

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Hope the results are good when Kevin next gets tested. It's bad enough worrying about the heart failure without having extra problems to deal with. Good luck.

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