BP MEDS

[Ireness]

My Candesartan was doubled last year to 32mg and my eGFR has steadily got worse. It was 62 and now 39.

Does anyone know any blood pressure medications that don’t affect your kidneys?

Or anything I can take with it to protect my kidneys?

Thanks

[happyrosie1]

the best person to talk this through is the pharmacist employed by your doctor’s group of surgeries (assuming you are in the UK). Failing that, your dispensing pharmacist.

Have a look at the website of Blood Pressure UK, as well, and see if there’s anything there that resonates with you. And they have a helpline.

[Ireness in reply to happyrosie1]

Many thanks for replying. I’ve tried that and they’ve just told me Candesartan protects my kidneys.

I’ll look at the website though …thanks for the information.

[MichaelJH Heart Star]

Hello! May I ask if you are pre-diabetic or diabetic and what other medications you are own?

Just over a year ago my eGFR plunged from 68% to 36% after I was prescribed the diuretic Furosemide for macerated wounds on my foot. Fortunately it then got stopped and my eGFR climbed back to 70% (probably the same as it is not the most accurate of tests).

The two BP medications that help protect the kidneys are ACE Inhibitors and ARBs (Candesartan) is one. I am on an ACE (Lisinopril). My dose was middling but was basically halved when my cardiologist added a low dose (1.25mg Bisoprolol) Beta Blocker to my array of tablets. This may be something to look at as dual therapy often provides better BP control as two actions are in place.

I do mot like your eGFR so keep on at your GP, If you get no joy ask to be referred . You were in Stage 2 kidney disease and are now in Stage 3. We need you to avoid Stage 4 (eGFR < 30%), Good luck.

Bear in mind I am not medically qualified but have a keen interest in diabetes, heart disease and PAD (Peripheral Arterial Disease).

[gbn_ in reply to MichaelJH]

Hi MichaelJH. May I ask, what your doseage of furosemide was? I'm currently on it at 40 mgs. a day. How long were you on it?

[MichaelJH Heart Star in reply to gbn_]

I was on 20mg per day for about five months approximately. A previous course in 2018 (dose unknown) was stopped after 4 weeks as another GP felt in unnecessary as oedema was caused by a temporary electrolyte imbalance following major surgery.

[Ireness]

Many thanks for replying.

I’m not pre-diabetic or diabetic. I’m on Dapagliflozin for my heart and Nebivolol. My arteries are all clear from recent CT scans.

When I’ve looked further at Candesartan it can harm the kidneys if taken long term and I think that’s what’s happening to me. It’s really very worrying.

[Butterfly65 in reply to Ireness]

I also take this med but only 4mg daily, so really not much compared to what you're taking. I've only been taking it since beginning of September,how long have you been taking it?

I hate that I have to take all of my HF meds but we have no choice do we?

My concerns from the start have been what damage they might do to my other organs if I have to take them long term & it seems doses start off low but always seem to increase overtime, which also worries me.

[Ireness in reply to Butterfly65]

I’ve been taking it for over five years (I can’t remember exactly).

I started on a low dose and my eGFR was okay even when my dose was increased to 16mg. The cardiologist doubled it last year and it’s rapidly gone down.

I don’t understand why my renal profile is checked then if it is showing damage I’m still left on the medication.

There must surely be something that doesn’t harm other organs like this.

[Butterfly65 in reply to Ireness]

I've just checked my last blood results to find my eGFR results at 55 which is worrying considering I've been on a low dose for such a short period compared to you. Luckily I have another appointment with either Cardiologist or HF nurses this Tuesday so will definitely bring it up.

[Ireness in reply to Butterfly65]

It’ll be interesting to see what they say.

[Ham1846]

hi I’m on 16mg of Candesartan and been on it for nearly 2 years now along with statin and blood thinners and had no problems. I’ve just had 1.25mg Bisoprolol added as my bp was still abit. They had already tried adding a diuretic and then when that never worked a calcium channel blocker which also never worked. I am prediabetic at present but trying to get the level down. Maybe your dose is too high for you now

[Ireness]

Many thanks for replying. I was fine on 16mg too. My BP is too low on the dose I’m on (usually 98/56 or lower)and I’m frequently dizzy and spaced out but they won’t lower it as they say it’s protecting my heart.

When the Candesartan was doubled I was put on the highest dose of a new beta blocker but the combination caused my BP to fall so much I had a fall and was admitted to hospital with a head injury.

The consultant there said she couldn’t go against a cardiologist but my meds were too much for me so I halved the beta blocker.

I don’t know what the solution is to be honest but if my kidneys get any worse there’ll be no point in protecting my heart.

[Hatchjd]

My husband had a similar drop in his GFR. He lost weight and became more vigilant about the amount of salt he was eating. He also had a consult with a private Kidney Specialist who explained that GFR rises and falls throughout the day and is influenced by many factors By weight, when you took your BP meds, how much fluid you have drunk, exercise, hormones, stress and even the environmental temperature if it is hot. My husband’s lowest GFR’s were the low 40’s but repeat tests over the past couple of years since loosing weight have been mostly 50’s and as high as 60. I would discuss with your concerns with your GP or Pharmacist.

[Ireness in reply to Hatchjd]

Many thanks for replying. It might be a good idea for me to pay to see someone privately.

I’ve lost a lot of weight and eat healthily. I don’t add salt to my food and keep well hydrated.

I take my meds at night and always have my blood tests first thing in the morning so that I get consistent results.

Something isn’t right but I’m not happy that I’m just being left to find out what is is myself. I can’t see the point in having blood tests if the GP & Cardiologist aren’t bothered by the results.

[Anothernewbie]

I cannot remember where I read it, whether it was here or National Kidney Foundation website, but I read that the kidneys have to work harder to process protein, and that kidney patients are sometimes advised to go onto a low protein diet. My eGFR was in the mid 50's. I went onto a mainly, but not completely, veggie diet for a week and my eGFR went up to 61. Since I weigh around 68Kg I try to stick to under 68g protein each day. There are apps and websites that can record this for you. In the meantime do get professional advice from your pharmacist, GP, or even nephrology clinic, because what worked for me may not be right for you.

[Ireness in reply to Anothernewbie]

Many thanks - I’ll try that. I don’t eat too much protein but I’ll try cutting it out for a while and see if it helps.

[Anothernewbie in reply to Ireness]

I don't cut it out, it is necessary, I just cut it down.

[BenThom-Wood]

Probably not is the honest obvious answer. Essentially blood pressure medication suppresses the heart rate & pressure of the blood in the pipes. 2 things the kidneys rely on. As the renal guy who saw me in Birmingham after a failed dialysis session (my blood clotted in the cannula after I had a eGFR of 6), if the pump fails who cares about the kidneys. Plus the e means estimated so perhaps it's not important to us cardiac patients, relatively.

[Ireness in reply to BenThom-Wood]

I’m sorry to hear you’re on dialysis. I hope you’re okay.

[BenThom-Wood in reply to Ireness]

Thanks, not on dialysis after that attempted session back in 2019. Just keep chugging the pills & buggering on.

[Ireness in reply to BenThom-Wood]

That’s even better 👍

[nilmonisikdar40]

Hi there, I am sorry that your eGFR has down considerably since you increased your sartan tablet for high BP. I looked it up and there is no clear connection between the two. Have you had your serum creatinine checked when you had your kidney function test. Are you sure you are not diabetic or prediabetic ? As usual your last port of call is your clinician either your GP of practice pharmacist. I don't think anything seriuous and you wil be reassured.

[Ireness in reply to nilmonisikdar40]

Hi thanks for replying. Yes my creatinine was normal and has risen to 120.

There doesn’t seem to be any obvious reason for the increase.

I’m definitely nowhere near pre-diabetic. All my other blood results are normal.