Yearly check at GP surgery - British Heart Fou...

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Yearly check at GP surgery

080311 profile image

Hello all,

Had my blood test, blood pressure, weight, at the surgery 2 weeks ago and for the second year my kidney function wasn’t very good. Had second bloods done earlier this week and have just heard they have stabilised, this happened last year.

I have a telephone appointment the week after next to have a talk with the nurse practitioner, I want to know if there is anything I can do to help myself. My potassium and magnesium numbers seem ok, I am on cardesartan does anyone know if this could be making my kidney numbers on the low side.

Thanks all as always

Pauline

52 Replies

Hello Pauline, sorry to hear about your kidney function, this happened to me when I had blood test in January, also had to undergo second blood test, and that showed it stabilised! 🤔

I take Frusemide and my GP was concerned.

However, I had blood test about 2 wks ago for everything, when GP phoned me I was pleasantly surprised that most of it was satisfactory. Thyroid fine, no need changing the dosage of thyroxine, cholesterol gone down from 5,5 to 5, ( I must be doing something right!) , no diabetes, kidney function ok, and liver ...I quote my GP: 'liver beautiful, you have a liver of a newborn!'

I was shocked! 🤣(pleasantly!)

However, she asked if I drink a lot of tea as I'm low on iron. Strange, didn't know that tea depletes iron from the blood!?

Well, I'm not a tea drinker...I have one cup in the morning...so...mystery!🤔

I have to wait for results of Vit D, that takes longer I was advised.

Also I will need to go for second blood test, as there is some inflammation showing, which could be pointing to polymyalgia rheumatica. Oh dear! 😱

I don't take cardesartan, so I'm unable to advice on that.

I hope you're well, Pauline!

You were the the first person here to reply to my first post two weeks after my AVR last July.😍

Take care , and I hope your husband is well too.

Monica

080311 profile image
080311 in reply to Nadeje

Hi Monica,

All my other tests came back ok this year had to go on iron and folic acid for 4 months last year this year they were fine just my kidney function again. Like you I am on frusemide so they are keen to keep an eye on my numbers. When I was in hospital my potassium level used to go right down every few days I had the most disgusting drink to take 😩 like you I don’t drink tea at all must admit love a really good cup of coffee in a morning.

I am doing well apart from my kidneys and John is doing ok. Had his booster shot and flu a couple of weeks ago.

I smiled at your Doctors remark about your liver as healthy as a new born. Lovely.

Take good care of yourself.

Pauline

Nadeje profile image
Nadeje in reply to 080311

Good to hear you're both OK! I too had my booster and flu jab and I continue being very careful!Wearing mask always indoors and especially on public transport which I use to a minimum! 💕

Stay safe! 😊

080311 profile image
080311 in reply to Nadeje

You stay safe too. It’s been lovely to hear from you.

Pauline

kizzie105 profile image
kizzie105 in reply to Nadeje

Good morning, I’m sorry to hijack your post but I was wondering if you could tell me what your iron level is? You said it was low. Had mine checked last month, GP said it was fine at 40 but a year ago it was 80, he said no need to take iron tablets unless I wanted to- not particularly helpful remark I thought! Thank you K

080311 profile image
080311 in reply to kizzie105

Morning kizzie105

Not sure if it’s me you are asking the question of anyway I will answer my level this year was 42 so wasn’t put on iron thank goodness. Don’t know about my folic forgot to ask. But they haven’t given me a prescription this time so it must be ok.

Best wishes Pauline

kizzie105 profile image
kizzie105 in reply to 080311

Thank you so much for replying, that’s helpful. I had a whole host of blood test done, I was told everything was fine but I have a copy of them now and some seem a lot lower than last time. Time to ask another GP to explain I think x

080311 profile image
080311 in reply to kizzie105

I live in Scotland and at my surgery we have a nurse practitioner who normally takes care of blood tests results and can write prescriptions I have an telephone appointment with her in 10 days she is on holiday next week so will ask a few questions. When we have a heart problem we become knowledgeable in lots of different areas 😂

Nadeje profile image
Nadeje in reply to kizzie105

Hi, I wasn't given any number...just was told I'm a bit low in iron. It never occurred to me to ask for a specific reading, this is the first time I've heard of this...I suppose I could ask my GP about it next time I speak with her. And as same as Pauline (080311)who is answering you also, I haven't been prescribed anything ...so I assume I'm fine.So, sorry, can't help.

purpleswimmer profile image
purpleswimmer in reply to Nadeje

Hello Nadeje, I see you mention polymyalgia rheumatic. Can you tell me what kind of pain you have that may be diagnosed as this? I have constant pain/tension in my neck and shoulders and a friend suggested I ask for a blood test for this very thing. Would be interested to hear your thoughts as many heart patients appear to have this pain. Xx

Nadeje profile image
Nadeje in reply to purpleswimmer

Hi purpleswimmer, I'm lucky to say I don't have any continuous pain.I was surprised at what my doctor said, that the blood test revealed some inflammation in my body which could suggest polymyalgia rheumatica.

And I need another blood test, which I haven't been given a date for so far.

I occasionally have a pain in my left hip joint, right knee, right shoulder. Nothing severe, so I would have to reach for pain killers.

But my friend has recently suffered dreadfully with pain in a shoulder and couldn't even sleep at night. Was told by a doctor it's a frozen shoulder. Had a private treatment as in acupuncture eventually. That helped only for a short while. Pain returned, she had a blood test ,it showed polymyalgia rheumatica. She is on steroids now.

My friend has no heart problems/disease.

Your friend is advising you correctly, I agree, do insist on a blood test and don't suffer with the pain.

All the best!

Monica

purpleswimmer profile image
purpleswimmer in reply to Nadeje

Thank you very much. X

Peileen profile image
Peileen in reply to Nadeje

Hi Nadeje My iron levels were low and needed three months of iron pills to correct. However, I am a tea drinker and never have with meals now. Then my white blood cells were low but have corrected at last blood test. I wonder if like me you don’t eat meat. I eat fish but because of diverticulosis can’t eat greens or peas and beans. I have found tahini which is rich in iron but find I am never out of the kitchen trying to get iron into my diet. Quorn doesn’t have much and I think it is about time iron content as well as protein were put on food labels. I feel duped by quorn and soya stating themselves as alternatives to meat. Good luck with your iron,

Nadeje profile image
Nadeje in reply to Peileen

Hi Peileen, I remember this problem with low iron has cropped up few times during my younger age...my Mum was same, and my daughter is. I remember also once I was prescribed iron supplements and it made me constipated.😏😟I don't eat meat often. I'm not vegetarian nor vegan. It is simply a matter of taste with me. There are so many meatless recipes, it somehow works that way for me to cook without meat. It's much more varied and tasty ! I love veg, eat all greens, pulses, grains, pasta. Sometimes fish.....out of meat it's usually chicken and that only once in a blue moon.

My tea intake is daily one mug of Earl Grey with soya milk in the morning. I love coffee but have only one cup in the afternoon.

Thanks for the tip re: tahini!🙂

I didn't know it was rich with iron!

I don't eat Quorn or soya.

I'm sorry that you suffer with diverticulitis which prevents you eating greens.

Hope I answered all you asked 🙂

Be safe

Monica

Sorry to hear that lovely Pauline. Is there a list of side effects from Candesartan somewhere online I wonder x

080311 profile image
080311 in reply to ITSINTHEBAG9

Hi Jane,Yes it does say it can cause numbers to fluctuate, hoping that when I speak to the nurse practitioner it’s maybe that. Just wondered if anyone had had that problem.

How are you? Think about you often. Hope your getting over the surgery without too many problems.

Very best wishes Pauline

ITSINTHEBAG9 profile image
ITSINTHEBAG9 in reply to 080311

Not too bad Pauline getting along. Back to work on 10th December. Only doing two shifts a week which will be quite enough for me at a GP Surgery. 😁.

080311 profile image
080311 in reply to ITSINTHEBAG9

That’s good to hear. Make sure you take care of yourself.

Pauline

Hello Pauline

Kidneys seem to be be a bit mysterious. My heart attack was in December 2018, and when I had a full set of blood tests 6 months later, I was looking through these results in Patient Access, and just had a look under the heading Problems and was surprised to spot the entry - Chronic Kidney Disease Stage 3! eGFR ml/min/1.73 m was 48. Immediately booked appointment with GP (remember the days when you were able to do this) and asked about this, the GP dismissed it saying "everyone over 50 has some kidney damage, yours is probably due to been put on diuretics, don't worry about it, we'll watch it with blood tests, it's unlikely to get worse"I just had some tests on my kidney function a few weeks ago, and the reading this time are eGFR ml/min/1.73 m = 65, so now in Stage 2 which is classed as mildly reduced function!

I have, as far as I'm aware, done nothing to effect this improvement beyond acclimatising to the meds I'm on! As I say, kidneys are a bit mysterious!

Russell

Evening Russell,

Thanks for that, my numbers last year were 46 and at second blood test had gone to 59, this year 43 and today they said it’s now 50. They said it was stable, just wondering if my Candesartan maybe the cause but as you say maybe my age😂

It certainly seems a mystery.

My GP (she's early 40s) politely suggested it was my age (67)! "It's your age" seems to be to go to answer a lot of the time😂Your figures seem to put you in the Stage 3 and your figures do look very stable, and as my GP said - there's a very big difference between Stage 3 and Stage 4. There's actually a stage 3A and a 3B - your numbers put you in 3A, Stage 4 is 15 to 29

From what I've read the suggestion seems to be that Candersartan either has no effect on the kidneys or even help to protect the kidneys!

Thanks Russell, did have a look at the numbers on line! There was a lovely pie chart that I was slap bang in the middle of. Sometimes you think ok I have a dodgy ticker and now I have another organ that needs to be monitored!Maybe it’s a case of walking a tightrope between drugs for your heart and keeping other organs functioning.

Again thanks for letting me have the information.

Pauline

nellie237 profile image
nellie237 in reply to 080311

Hi

I think its a balancing act. Damage to kidney function from the high blood pressure versus impact from blood pressure meds.

You should however, be aware that if you have a severe stomach problem eg Norovirus, then you need to discuss with your GP stopping BP meds for the duration, as this can make us particularly vulnerable to Acute Kidney Injury .

There is quite a lot of evidence that cutting down on protein helps.

080311 profile image
080311 in reply to nellie237

My blood pressure is on the low side, though I am on candestatan and Bisopropol plus Frusemide and the usual aspirin. Have no stomach problems. As I have said before it’s like walking a tightrope between taking the drugs to help our heart and not damaging other organs, hopefully after my conversation in 10 days time I might have a better idea what is going on. I thought it was the candestatan but maybe not from what others have said. My potassium as come back ok so don’t think it’s that,

Thank you for replying .

Best wishes Pauline

nellie237 profile image
nellie237 in reply to 080311

"I thought it was the candestatan" I think you are probably correct. I think the 'benefit' to kidneys comes from lowering high BP.

If you don't have high BP, it might be time to discuss coming off it.

Low BP will slow down your eGFR.

080311 profile image
080311 in reply to nellie237

My medication was prescribed after my surgery and it’s them that are keeping my blood pressure down. Between 105/59 to 110/62 I have my 5 year review next June for my Aortic valve replaced and bypass, though by then it will be 6 years! So maybe something I can discuss with my cardiologist.

nellie237 profile image
nellie237 in reply to 080311

Ah, is it usual to keep BP that low after valve replacement & bypass?

I mentioned stomach issues for future reference really, as I think it is something everybody on BP meds should be made aware of, especially anyone with already compromised kidney function.............. and GP's don't tell patients.

BP meds are the 3rd biggest cause of Acute Kidney Injury. There was a big NHS campaign in 2016........"Think Kidneys" because GP's etc were not reacting to eGFR until stage 4 CKD.

thinkkidneys.nhs.uk/

[Edit: This is more up-to-date thinking:-Review on 2020 guidelines]

karger.com/Article/FullText...

hi i also have CKD at the moment it’s stage 3b.. egfr is 35..it August it was 39.. lowest it’s ever been was 29 which is stage 4.. was in hospital with angina and they decided to put me on a potassium/sodium iv for 2 days to get it up to 31 lol.. thing that concerns me is last week the practice nurse took bloods for Hba1C.. but didn’t do one for kidney function.. usually done every 4 months.. said won’t be done till next Sept..i’m a bit concerned about that to be honest.. God knows how i’ll know if it gets down to under 30 again

080311 profile image
080311 in reply to Manhattan1

So sorry to read your having problems too. When I was in hospital for the 7 weeks before my surgery I was on a diuretic drip twice a day to get get rid of the excess fluid and every couple of days would have to have a potassium drink (awful) my potassium as come back today at 4.6 so think that’s ok. Will have a conversation with the nurse practitioner the week after next to clarify a couple of things.If I were you I would be asking for a blood test before next September just to make sure your numbers are not going down.

This tightrope we walk between drugs to keep our heart ok and not causing us any damage to our other organs can be quite difficult!

Hope you can get your numbers up. As Spiritoffloyd GP told him sometimes it’s an age thing😂

Best wishes Pauline

hiya😀.. to be honest i don’t even know what problem low potassium causes.. i thought i was just on a normal fluids iv.. but when my bed was being wheeled into another cubicle one of the nurses noticed the drip and called out ‘be careful it’s potassium!’.. sheesh she gave me a fright lolol.. i’ll certainly not be waiting till next Sept for a kidney function blood test👍

080311 profile image
080311 in reply to Manhattan1

That’s great, I have my 5 year review next June though it will be nearly 6 years so I will have a conversation with my cardiologist and see what he says. Take care

Pauline

you take care too Pauline

Helen

Hi Pauline

You are such a star ⭐️ on here and I was surprised to hear of your difficulties. Shouldn’t have been, as you always help others but always say you’re OK 👍

I’m glad you’ve asked the question as it will help many of us to know the answer as you know.

I do hope you get a good result and will keep checking on you.!

Regards

❤️Maisie❤️

Oh Pauline I'm so sorry to read you've had a bit of a scare. You're so kind to everyone here. Glad the problem resolved but would be interested to hear what the nurse practitioner says, many of us take the same cocktail of drugs as you, so knowledge from each other always helpful. Meanwhile stay well and stay safe.Frances

080311 profile image
080311 in reply to francesw47

Morning Frances,It’s just that this happened at last year’s bloods as well, and they just said it had stabilised at the repeat test so I thought it was just a blip. Anyway will try and follow it up this year and try and get some answers. The nurse practitioner is great but she is on holiday until the 29th so I will speak to her when she is back. At least all my other results were ok😂 I will certainly post if I get some answers.

Hope your doing well, you stay safe.

Best wishes Pauline xx

Hi Pauline,My kidney count is low too - 39-41. A healthy kidney is 90. I'm classed as having Chronic Kidney Disease (apparently the 'chronic' just means long term). I am on Losartan 100mg daily, and yes I do think that the meds could be a factor. I have also read that your kidneys do not heal themselves like your liver does. Must admit to being a bit worried, but my doctors don't seem to be as they don't do regular blood checks unless I ask them to.

Not sure what the answer is, the Losartan seems good at keeping my bp in check so a bit worried to change from it - I had tried three different meds before that didn't suit me.

You're lucky your surgery gives you yearly checks. Mine doesn't. I'm 71 by the way.

Best wishes, Denise

Morning Denise,

Last year when my number was low I didn’t question it, the repeat bloods came back and was told doctor was happy it was now stable. But this year’s test the number is down again the repeat bloods it has gone up a wee bit and again told it’s stable. Have a telephone appointment with the nurse practitioner in 10 days just to ask her a few questions wether this is happening because of my medication or is it something else. My count this year was 43 at the first test and the results yesterday 50.

I think I must be lucky as you say I just get a text saying I am due my yearly check, that’s blood pressure, bloods weight and if I have any concerns. Had a text this week to say I haven’t had a Shingles vaccine so would I make an appointment. Didn’t remember I haven’t had one. I will be 74 in another week so a wee bit older than you.

Stay well

Best wishes Pauline

Candesartin can affect the kidneys I was told. When I had my AVR 6 weeks ago, I had acute kidney damage caused by the bypass machine. I was taken off Candesartin from the surgery onwards. Fortunately my blood pressure seems OK now and I don't need to go back on it as the doctor at my 6 week phone consult said it would be bad for my kidneys. I hope your issue resolves quickly.

080311 profile image
080311 in reply to WeaverShaz

Isn’t it funny, you have posted that Candesartin can affect the kidneys and a couple of others have said they can protect the kidneys! My AVR was 5 years ago and have been on this drug since just after I was on Ramipril but had the dreaded cough! Seeing my cardiologist next June for my 5 year review (though it will be 6 years) will see what happens over the next few months.

WeaverShaz profile image
WeaverShaz in reply to 080311

Just what I was told.

080311 profile image
080311 in reply to WeaverShaz

As I have just said to someone else every day is a day in school even at the age of 73😂 I am really grateful for your post and just gives me more questions for my nurse.You take really good care thanks again.

Pauline

PecanSandie profile image
PecanSandie in reply to 080311

I researched this a little bit because I was taking Losartan/HCT for years and my kidney function kept dropping. My doctor couldn't believe it was the drug since it's supposed to be protective of the kidneys. Also, I always suspected it was the HCT part of the drug that was causing my problems. Finally when my eFGR dropped to 33 she prescribed a different medication. (Keep in mind my high blood pressure has been a nightmare to treat.)

In the meantime, I started doing some research and found out that Losartan is supposed to be protective of the kidneys except in some cases where it isn't! There are some studies out there saying it's not good for some people.

Since I stopped the Losartan my eFGR has risen to the high 30s.

No one really knows the answer whether it was the Losartan, the HCT, or something entirely unrelated that caused the drop in eFGR (I was probably eating more salt at the time than I should have!)

080311 profile image
080311 in reply to PecanSandie

As the SpiritoftheFloyd said earlier kidneys seems to have a mystery all of their own! Hope your number continues to rise.

Best wishes Pauline

Hi Pauline,

During a visit to A&E recently with chest pain (not another Takotsubo as I suspected, thankfully!), they discovered I had very low sodium (hyponatremia) so kept me in. After tests and scans, they narrowed it down to the candesartan and took me off it and restricted my fluids. I was in for five days and my sodium level crept up to almost normal, so I was discharged. I'm now waiting on the result of a two-week repeat of the test. I don't know what my eGFR in the hospital was, but I'll find that out too.

080311 profile image
080311 in reply to Ramilia

Thanks for that, the different things that are happening with Candesartan is amazing. Hope your feeling better by now and your test come back all good.

Best wishes Pauline

Ramilia profile image
Ramilia in reply to 080311

Thank you. I hope your results stay stable too. Take care.

Hi Pauline,

I wouldn't be too concerned over your eGfr. If I had any query, it would be the fluctuation in the reading, as I'm forever being told there may be minor changes, but nothing major.

My renal function collapsed during my 2nd surgery with an eGfr of circa 35-36 for eight years or so. Since the introduction of heart meds earlier this year, it dropped to 29-30, where it's now stabilised for 3 months. The HF team were concerned that Entresto would further reduce my function, but, to date it's held its own, that said they've held back on increasing the dosage.

My GP has me on a 3 month bloods test now, but isn't overly concerned, so if they're not, neither am I. I'm told it would have to drop significantly further before any form of intervention.

Take care

Heed

080311 profile image
080311 in reply to Heed61

Morning Heed,

Thanks for that, will certainly ask at my appointment about the fluctuations in my numbers as you say, what do they say every day is a day in school even at my age😂

Best wishes Pauline

I've not read down every response to your post but. I was in the anaesthetic room prior to valve replacement surgery. The consultant anaesthetist did a blood test and came back and after a consultation with my surgeon told me that they would have to delay the op as my potassium level was through the floor he said he couldn't guarantee to waken me up.if they went ahead. He blamed it on Ferusimide. I was kept in hospital for a week and force fed a potassium drink. I found that the easiest way to take it was with as little water as possible! After the op the following week I was prescribed Co-Amilifruse which doesn't seem to drain potassium.

I was on a diuretic drip for the 7 weeks before my AVR and also had the potassium drink every few days it’s not the nicest thing I have ever had 😂

Hi I’m glad you are getting these routine checks done. They have been stopped in my surgery since covid. Hopefully your kidney results are only temporary as some tests can be. I got blood tests earlier this year due to tiredness. My iron levels were low and needed three months of iron pills to correct and I notice some discussion on your pist about iron levels. I am a tea drinker and never have with meals now. Then my white blood cells were low but have corrected at last blood test. I don’t eat meat. I eat fish but because of diverticulosis can’t eat greens or peas and beans. I have found tahini which is rich in iron but find I am never out of the kitchen trying to get iron into my diet. Quorn doesn’t have much and I think it is about time iron content as well as protein were put on food labels. I feel duped by quorn and soya stating themselves as alternatives to meat. Good luck Pauline and hopefully subsequent blood test results will be ok for you. Apologies as well for the iron statement.

080311 profile image
080311 in reply to Peileen

Hi,

I too have diverticulitis and as you say it’s a real pain with eating vegetables. I used to love seeds and grains but again not good for my system!

I think reading the posts I think my kidney function is something I am just going to have to manage. I bit like you we eat very little meat have replaced beef mince for pasta with Quorn. I was pleased that my blood count this year was ok, and didn’t need iron again.

Take care.

Pauline

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