BP Meds

[Wrigley]

I'm on Lisinopril and a Thiazide combo. My most recent eGFR was 54. BP Ranges between 105/65 to 115/70. Any thoughts on role of BP control and eGFR management? How important is it?

[MAS_Nurse]

Hi Wrigley,

Take a look at the link to our website below. It is really important to reduce high blood pressure (hypertension) in CKD as it damages the kidneys. High blood pressure increases the risk of heart disease e.g. strokes and heart attacks. The kidneys play an important role in controlling blood pressure, and regulating hormones which affect the tension in blood vessels. They help remove toxins and waste products, they regulate salt and water in the body. It is important to take medication to reduce hypertension and make lifestyle changes. eGFR is the rate at which the kidney filter waste products from your blood, and is often expressed as a percentage of normal e.g eGFR 54 = 54% . So as you can see how the link between blood pressure and eGFR is important, and why it is important to reduce hypertension by medication, diet and lifestyle changes e.g. dietary salt reduction, regular exercise, etc. See the link below for more information.

Kidney Research UK - Blood pressure: kidneyresearchuk.org/health...?

Hope this helps.

Best wishes,

MAS Nurse and Moderator

[Wrigley in reply to MAS_Nurse]

Will do. Thank you. Is there an optimal BP in Stage 3?

[RickHow]

Your bp is excellent. My doctors (kidney, gp, cardiologist, urologist, cancer) tell me people pay too much attention to the common notion that bp should be 120/70. That this is NOT true. It is dependent upon your age. Our bp increases normally with age. I'm 69. They recommend that I keep it at no higher than 135. However, I take, like you, lisinopril and amlodipinine, and my numbers are usually 12x/6x. There is a school of thought that lisinopril can be helpful to the kidney for other reasons and not just bp. However that lisinopril can also LOWER your egfr. In fact 2 months ago they had me reduce my lisinopril from 20mg daily to 10mg. To see if my egfr would increase, and yet if my bp would still be under control. The results were surprising! Cutting my lisinopril in 1/2, my bp remained exactly the same. My egfr went up only slightly by 3 or 4 points. So I was taking the larger dose of lisinopril unnecessarily. Next they said, lets try that with the amlodipine I was taking for bp. I went from 5mg daily to 2.5mg. Same thing. My blood pressure remained the same. This reduction had no effect on my egfr. Talk to your doctor about this. You should never self medicate. But your bp is low enough that you might be over medicating.

[Wrigley in reply to RickHow]

Thanks for the thoughts. I'll look into that.

[Zazzel in reply to RickHow]

I agree with RickHow on the fact that the meds can reduce your GFR, however, IF you have Protein in your urine, Lisinopril is the go to blood pressure med that helps reduce proteinuria. I have reduced my Lisinopril to 1.25 mg which is half the lowest dose. It has brought my blood pressure into a normal range and reduced my proteinuria to a normal level.My GFR has gone up and down within 10 points since starting Lisinopril so for me, the small dose doesn't appear to be factoring into that, though I'm sure a larger dose might lower it.

[RickHow in reply to Zazzel]

Yes I too should have mentioned that Lisinopril is good if you have protein in urine. It is interesting too that you find such a low dose, and I too find a lower dose, does a good job.