decline in renal function on HBP meds

hi just joined this group .

Been on medication for 39 years after birth of twins. BP been difficult to control until max dose of sporonolactone 6 years ago. Have mild diabetes, no treatment and high cholesterol, don’t tolerate statins. Been getting regular bloods with diabetic nurse at new practice for past 3 years. 2 years ago I noticed my renal function had dropped below 90 and continued to drop at each check. Not unexpected given spoilt for choice with contributing conditions Didn’t actually meet a doctor until last summer mostly phone appointments due to covid but did keep bringing up as drop in function now down at 74. But they don’t seem to get concerned until it’s below 60 I work in hospital have seen end stage CKD so eek kinda worried when it went to 64 last sept and I developed muscle pain and stiffness. CRP went up to 240, rising creatinine , potassium 6 and low sodium Saw 4 different doctors and last very astute doc diagnosed PMR and thought renal decline due to spironolactone and I stopped taking it. Renal function bounced back to 87 Potassium dropped to 4 still bit high, sodium still low not sure what’s going on there and CRP down to 4 on prednisone for PMR in December 2022.

Now trying 2.5 mg bendroflumethiazie and weaning off steroids. None of this lot good combination of conditions unfortunately but getting there. Can’t blame doctors for not picking up none of them know me as it was a new practice but I think that’s common for most patients nowadays not having designated doctor and PMR still pretty unknown to most GPs Going back for more bloods in a month so hopefully new meds bit kinder to kidneys 🤗

[Happyrosie]

I do hope it will all sort itself out for you.

[Brisk61]

how worrying for you but you appear to have a good understanding of the condition which is great. Hopefully a less harsh diuretic will allow a recovery of the kidney function. Wish you lots of good health.

[Hidden in reply to Brisk61]

thank you. Im not too much of a worrier about my health in general. Was more annoying it seemed to be being ignored I think it’s accepted there is a risk from long term diuretic use which I was aware of but had forgotten as I’ve been on them for so long . So post is more to raise awareness that declining renal function should be checked out above 60, even when there are several other risk factors (diabetes, age, HBP) it can be attributed to and like mine can go back to normal. Be nosey at the docs and get an awareness of all your results they (doctors) are not infallible Though I know this might worry some people with minor fluctuations of no real significance so perhaps not for everyone

[katieoxo60]

Hello Angrybirds , nice to meet you. I have just been informed my kidney function is low but not how low . They told me this about three years ago when I had a check for contrast medium MRI. But as you say don't do much about it just regular blood screen. I have had high BP for years and long term treatment until recently when I started to get raised uric acids and higher blood pressure. So as you see you are not alone, I have been advised to keep hydrated and given Losartan at 50mg but I don't feel good , get up in night several times and have a terrible taste in my mouth in a morning , how about you? Do steroids effect the blood pressure? I had to stop the diuretic as long term it causes raised uric acids and I ended up with a gout attack. Steroids are used for arthritic pain and for lung conditions I have both. Theres no happy medium is there? hope you can work it out with your new doctor. Best Wishes

[Rachmaninov2 in reply to katieoxo60]

I have very recently been informed that I have “low functioning kidneys” eGFR stable at 50, and have asked to be referred to a dietitian. I’m not sure if it’s a condition that can be reversed. I have been taking prednisolone for Polymyalgia Rhumatica and Inflammatory Arthritis for about three years and I have high blood pressure.

[katieoxo60 in reply to Rachmaninov2]

You are right I don't think it can be reversed but changes can maybe slow up the process. My files show me as CKD 3 my freind up the road is on dialysis. Plus as we get older the kidneys slow down like everything else so diet change can put less pressure on them. The BP can cause problems if its raised so we can only try our best to keep things the best we can . Long term raised BP can cause other problems too. Its a case of weighing up the best solution given health issue for yourself as many pills cause changes I believe especially with long term use.

[Rachmaninov2 in reply to katieoxo60]

I was told by my rheumatologist that it can be due to ageing and I know that some of the medication I’m taking can also have an effect, also taking 7.5mg Methotrexate a week. I have been taking Amlodipine for about three years and my GP has now prescribed Losarten 50mg as he says it “helps the kidneys.” I think I’m at stage 3 CKD.

[katieoxo60 in reply to Rachmaninov2]

Guess the sum total is we have to make the decision as to what is best for us using trial & error I am not sure about Losarten , it has a long list of ifs and buts including if you are taking other blood pressure medication or have kidney function reduction. So I would proceed with care and keep note for your GP of any anomilies that might be caused by the tablets or health matters . Take care .

[Rachmaninov2 in reply to katieoxo60]

Thank you katie. I remember the advert from many years ago!

[Hidden in reply to Rachmaninov2]

Unfortunately only way to check if it’s medication is to come off it. Both myself and GP thought good idea particularly given a very high potassium of 6 , any higher and they whip you into hospital to stabilise. 🤗 My reversal in renal fiction and creatinine perhaps rare and unusual .

My blood pressure has been on high side again since coming off diuretic and new one not as effective. Not sure if this is affecting kidney function yet as not had another blood test.

agree with Katieoxo watching diet can reduce pressure on kidneys, but you should be getting dietary advice from nephrologist or support nurse

[Rachmaninov2 in reply to Hidden]

Glad to hear that you have had a reversal in renal function and creatinine Angrybirds. I am realising that I need to drastically cut my carbs, and modify the rest of my diet. Have asked my GP to refer me to a dietitian but not holding my breath. I was told by my rheumatologist about the condition of my kidneys as if it was of no consequence. No info, dietary advice or mention of a nephrologist or support nurse. So your advice is greatly appreciated!

[Hidden in reply to Rachmaninov2]

I found a book by Lee Hull stopping kidney disease food guide which had a lot of useful info. Don’t get his other one not helpful. However you have to be careful with renal diets as they must be appropriate for your level of condition as your body has different needs at each stage. But in general this is a heathy diet nothing too complicated. Check out foods high in potassium and watch intake they make kidneys work harder as does too much protein and carbs Get some superfoods. Blueberries cranberries raspberries ect. I started on hibiscus tea but you need to be careful on BP MEDS as it can make your blood pressure too low so only if you check yourself with a BP monitor and no more than 3 cups a day. Do as much research as you can before starting anything and watch for contraindications but be wary bit of conflicting info out there. Start small so you don’t get disheartened and get medical/nurse/ dietician back up if possible if not healthy eating less carbs less protein reduce salt watch potassium exercise and good luck 🤗

[Rachmaninov2 in reply to Hidden]

Many thanks for this detailed reply. The information you have shared will help enormously while I am waiting to hear from a dietitian. I do regularly take my blood pressure readings, and I am attempting to walk as much as possible. Not as much as I would like as I have mobility problems. I appreciate your help. 😊

[Hidden in reply to katieoxo60]

not sure if steroids affect blood pressure but one doctor said they put extra strain on heart However at moment they are playing havoc with my glucose levels, have mild diabetes and had to make a phone appointment today to get meds to bring it down Ah the joys of old age never rains but it pours 😆but on plus side PMR been feeling better 🥳 thank you for coments take care 🤗

[katieoxo60 in reply to Hidden]

Good luck with your appointment its very difficult when you have more than one health issue , hopefully soon your issues will settle down , all I got from visiting hospital about my eye problem was more problems. Sure its some of the side effects of the drugs I take or maybe worsening health due to age. Theres no cure for these health issues just treatment for symptoms they cause which ironically can cause further unwanted issues. Enjoy your day and take care

[phebamom in reply to katieoxo60]

Please read my other posts in this thread. Is it possible you have sleep apnea. I was waking up feeling so horrible I would ask myself every morning, "why am I not dead". that is how bad it made me feel for last few years. Fourth night on CPap machine, and in spite of a constant battle getting used to face mask, I am feeling better in the morning.

[katieoxo60 in reply to phebamom]

Thank you phebamom , I have been tested for sleep apnea in the past , I have to get up in the night due to waterworks which I beleive is often to do with Kidneys as well as a weak bladder from vaginal hysterectomy. My blood pressure as always been raised for many years, waterworks have been up and down including blood in the urine, I also had a kidney infection very severe in my younger days during my menstrual years. Some of my chest problems do have an inherited source. And the rest of it may have an age factor. My mobility is due to arthritis and I find it very difficult to speak to doctors but I am glad to hear you are being heeded and getting the tests. Of course anyone can suddenly get a change in health that may be something new. Like my age cataracts. Best wishes

[phebamom in reply to katieoxo60]

I had a total hysterectomy for endometrial cancer in 2004, so we have a lot in common. Did they take your ovaries when you had your hysterectomy? We women can have profound problems stemming from our female chemistry. Way back in 1973 I was living with my grandmother. She would lie in bed at night crying in pain because the arthritis in her knees hurt her so bad. She watched a show called "What's My Line". The star was a guy who wrote a book called : "Arthritis and common sense". The author proposed taking two teaspoons of cod liver oil, in a tiny bit of orange juice once a day. My grandmother tried it, and her pain went away after 6 weeks and never came back, ever! She lived to be 98, and until the last two years of her life she took her cod liver oil every day. I personally could not handle taking the concoction. Yuk! But, grandma swallowed it down, wiped her lips with a napkin and carried on. Of course this was a woman who chewed tobacco and swallowed. Ladies didn't spit. She was a very tough woman.

[katieoxo60 in reply to phebamom]

Yes we do seem to have many things in common , I had an open surgery gallbladder removal long before the new tech they use now, followed by a total hysterectomy within two years I did have my ovaries removed as I was already sterilised. My joint problems flared after the Hysterectomy, I was told it was because of two major ops so close together, your grandmother used the option of choice in those days, my gran lived to over 90 crippled with arthritis but unfortunately my father did not but he took many tablets so it does make you wonder. I think you can get codliver oil in capsules now but there are many other herbal remedies and they do work for arthritic pain . I have pain in my back but its soft tissue not arthritis as such . At least my knee op allowed me to weight bear again. Oh how times have changed but people do survive often with no particular special NHS treatment, but others could have been pain free if treated with new things. Must go now decorator coming tommorrow and I am trying to be as organised as possible. Enjoy this dry weather while it lasts but do wrap up warm.

[phebamom]

spironolactone is often prescribed for a growth (benign) in the adrenal glands, or overactive adrenal glands that make too much aldosterone. Have you been blood tested for over-active adrenals making too much aldosterone. Spironolactone is a very powerful diuretic that also stops production of aldosterone. There is a similar medication that is milder. I can not remember the name of it. Spironolactone is on the list of the 10 worst medications for kidneys. I am on Valsartan, 80mg. 2 x a day, and Carvodilol 25mg, 2 x a day. I am trying to wean off of the Carvodilol. It is a horrible medication, and it does not help my high blood pressure. I also have kidney issues. Waiting on results of ultrasound of kidneys. Just diagnosed with severe sleep apnea. Doctors suspect it may be the cause of my high blood pressure. Stop breathing 54 times an hour. Sleep doctor told me that I would continue to spiral down until I died if I did not treat the sleep apnea. 4th night on CPap tonight. Very hard to get used to. A lot of things can cause high blood pressure. I saw my rheumatologist two days ago. He said the 5mg. of prednisone I am on is not high enough to be causing high BP. He seriously suspects the sleep apnea as the root cause of most of my issues. I have PMR/GCA. 20 years.

[phebamom in reply to phebamom]

PS. I am not obese, 165# 5,8", 57 years of age. I also do not snore. Took an at home, overnight sleep apnea study. Results blew me away. I do not fit the average sleep apnea patient profile. My rheumatologist was amazed and said he wished he had thought to test me. Ordering the test was my ideal. We must be our own advocate. Doctors, especially specialists can't think of everything. Come to find out, I have inflamed adenoid tissue and a tiny airway. Who knew! My big mouth can get me in trouble at times, so the tiny airway came as a surprise. Sleep apnea is genetic and as severe as mine is, usually leads to an early death. My sleep doctor told me I could easily die my sleep. O2 sats drop to 72% many times during the night. Am wondering if sleep apnea is why PMR/GCA will not go into remission, and why no amount of medication will control high blood pressure. Time will tell.

[Hidden in reply to phebamom]

no don’t think I have an adrenal problem ACE inhibitors not particularly effective beta blockers don’t tolerate so was kinda last resort that seemed to work. Was actually trying to get into a clinical trial for surgical intervention a few year back but the BP was too normal in spirolactone to include me so just stuck with it and change of doctor practice and covid and kinda got lost to BP monitoring. Must admit I’m happy to ignore things and not go to doctor if not bothering me so own worst enemy but do more research on it. Thanks for info. Hope you get yours sorted

[phebamom]

Are you on a proton pump inhibitor? I was on Prevacid for a year for a bleeding stomach. Stomach is healed, but primary told me that PPIs can cause high blood pressure, and also elevate creatinine. I had a tough time getting off of Prevacid, two months ago, and my body is still adjusting. My stomach feels better off of it. I still have elevated creatinine, and blood and protein in my urine.