My name is Brian and I'm new here. I am a 55 year old male. I have had a very low level of protein in my urine since 2017. All bloodwork was normal, however, for my age. I attributed the protein in my urine to taking PPI medications for many years since my mid-30s.
In 2019 I opted to have a surgery to correct issues with my reflux as I was told I had Barretts Esophagus. I also wanted to get off the PPIs. The surgery went well (no complications) but it didn't fix my reflux.
In 2022 I opted to have another surgery for the reflux because I was told I had a hiatal hernia that was too large to make the previous procedure effective. Unfortunately that procedure went sideways and now I have an extremely large hiatal hernia (75% of my stomach in my chest).
This caused my heart rate at rest to shoot up. Upon meeting with a cardiologist, I was prescribed 25mg of Metoprolol daily. It dramatically lowered by heart rate so I switched to 1/2 of that for about a year. After the first year I went to the 25mg daily as originally prescribed because it seemed like it wasn't effective anymore at the 1/2 dose.
In June of 2023 I had routine bloodwork done and my egfr was 91, creatinine at .99. About 9 months later I had routine bloodwork done again in preparation for surgery on the hernia and the egfr dropped to 82, creatinine at 1.07.
I have made an appointment with a nephrologist as Mayo in Scottsdale. I'm pretty nervous that the metoprolol has been damaging my kidneys even at the 25mg dose.
I have read conflicting information about metoprolol and issues with the kidneys. From what I can tell, most CKD people take carvedilol for their BB. Does anyone have any experiences with Metoprolol and kidney issues? If so, did you see any improvement upon discontinuation of that particular drug?
I am hoping to have the hernia corrected this year but I'm worried my kidneys are on a downward trajectory now.
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I have ESRD (my GFR is 13) and take 50 mg Metropolol along with 3 other BP meds. I’ve never heard of Metropolol being bad for your kidneys. My nephrologist is the one who put me on it. Were you well hydrated when you had your bloodwork done? If not, that could account for the drop in GFR. Your GFR isn’t too far below normal, so if you do have CKD, you can slow down the progression with diet and exercise. There is a lot of good information on the NKF website at kidney.org. Good luck with your appointment with the nephrologist.
Thank you for your reply. I don't recall my hydration level prior to the last bloodwork but I have not been great about keeping hydrated if I'm honest. I will also check out the website, thank you.
Whilst reading your post, I initially planned to advise you to consider Nutritional Therapy (NT) instead of medication since allopathic medicine does not appear to have helped your various conditions. My mum (ckd 3) only adopts NT.
However, from your post, I sense you may not be as committed to that alternative approach as you would need to be. So I can only agree with the other suggestions of further medication.
I have CKD 3 and have only recently been diagnosed, but when I checked my medical records it said I had this a few years ago? I've been told that GP,s don't have to tell you?? I also have a heitus hernia and bad acid reflux. Anyway thank you for all advice on here and I'm going to look into NT as I want to prevent it getting any worse.
Yes most people aren't told by medics until later stage eg 3a or later. My mum was never told - dad discovered by chance via online records!I believe it's cos medics can't help earlier but can offer things like dialysis later. It's totally wrong as patients can do something via NT.
A key added benefit of NT is it often helps other conditions improve too because it helps the body recover. For example, mum was able to wean off BP medication years ago and is 115/75 nowadays.
My nephologist put me on metoprolol about 3 years ago, 25 mg in the morning and 25 mg in the afternoon. My gfr is 31 and has stable around this number for a dozen or so years. There has been no gfr change since taking metoprolol. I also have a very large hiatal hernia (1/3 of my stomach is on my esophagus) and I've been told it was caused by silent reflux for quite a few years that was not treated. I now take 20 mg of omerprazole and watch my diet which appears to be managing this condition well at the moment. I am not eligible fir surgery because of my age. A very knowledgeable surgeon at the time told me that the position of my hernia was not problemstic and that woukd be helping me deal with this condition. An important thing to remember is that we are all vert different so we have to be careful when we take the experiences of others to explain our own. The best of luck with your situation. Remember to watch your diet and especially stay hydrated.
I agree that PPIs are probably to blame for my CKD. However, my drop in egfr was very significant in a short period and the only change in my regimen is the BB.
Blood pressure medications rarely cause kidney damage; they prevent kidney damage. The damage to kidneys is from the high blood pressure itself as it pounds (and breaks) the tiny filtration vessels inside the kidney. Usually, a person with high blood pressure starts at a lower dose of a lower tier form of medication. If blood pressure rises more, then one can be moved to heavier forms of blood pressure meds. Indeed, one can eventually take 3, 4, or more forms of blood pressure meds daily to prevent issues. In my husband's case, eventually no blood pressure drug could help him - his blood pressure went to 240s/120s and only dialysis could bring it down. In your case, Metoprolol is a very mild blood med for blood pressure control. If it's bringing down the pressure, and you have few, if any, side effects then you're very blessed. It's doing it's job. In summary, always remember to put the horse before the cart - namely, high blood pressure, not the pills, that damages the kidneys.
You mention proteinuria (protein in urine). Protein is supposed to remain in the body. Every cell in your body requires protein. If there's a teeny tiny bit in your urine, it can be normal. For example protein carrying cells can naturally slough off the walls of your urinary tract system and wind up in the urine. But other matters can surface too - a urinary tract infection for example can also put protein in your urine. Interestingly, my husband now has a transplant. His transplant center suspects some of his proteinuria is from his native kidneys slowly shrinking. If it's traced to your kidneys leaking protein, then you'll definitely want to keep an eye on it. Our nephrologist explained proteinuria this way: " The kidneys are like a boat, the more holes in the boat, the quicker it will sink." The two leading causes of kidney disease are diabetes and high blood pressure - both very adept at "poking holes" into your kidneys filtration system. So please keep a close eye on your numbers - that's your guide if things need to change. Sadly, we've learned all of this hard way, I wish we had known this from the outset, it would have saved us a lot of trouble. I hope you find some worthwhile direction from our experiences.
Thank you for your detailed reply! My blood pressure has been pretty good over the years as I was quite active in running prior to an ankle injury. Also, my blood glucose isn't great (around 100 typically) but my A1C is usually around 5.5. I have been keeping an eye on my sugar intake for years now because of the glucose being above the high level. I hope your husband is doing well with his transplant.
Your A1C number is great, and Metoprolol seems to be keeping your blood pressure in check. Following his transplant, my husbands blood pressure meds were tweaked by the nephs there. Like you, he was placed on Metoprolol; he reacted poorly (dizzy, fatigued) to Carvedilol. Your creatinine is very good - you'll find the nephs pay a lot of attention to that, not so much eGFR. It might be worthwhile to keep an eye on the PPIs.
Hi! Sorry to hear your having such terrible issues with GERD. I too had a large hiatal hernia and awful Gerd. They did a procedure called a nissian fundoplication about 5 years or so ago and so far so good. Your egfr should be 60 or above so if I am looking at it it seems fine but that is something you would need to talk to your doctor about. Mine is 35 and I only found out in October 2023 after years and years of 800 mg motrin. So no NSAIDS which with my RA is terrible! Glad you're here! Take care!
Glad you were able to get your HH sorted out. I'm hoping I will have surgery for it soon. I had a TIF done in 2020 but that didn't work because they underestimated (or it grew) the size of the HH. The second procedure was to just repair the HH and it all came undone in the recovery room. Hopefully you will be stable at 35 for a long time!
I've taken metoprolol with CKD for several years with no ill effect noticed. Good luck, this is not an issue. Just eat a kidney healthy diet and enjoy your days.
There have been numerous studies that link proton pump inhibitor long term use to kidney disease, even kidney failure. There are class action lawsuits over this.
I read a meta-study dated March 15, 2023. Results of 6,829,905 participants were analyzed from 10 studies total. Compared with non-proton pump users vs people who use them, those who used them were significantly associated with a higher risk of CKD.
You will find that study on the National Library of Medicine, Pub Med Central. It’s from the Journal of Clnical Medicine. The title is “Proton Pump Inhibitors and Risk of Chronic Kidney Disease: Evidence from Observational Studies.”
I would not be concerned about a beta blocker at all. I suggest you bring this up to both your GI doctor and your PCP or nephrologist if you have them. Print it out and show them. These are scientific studies. These are not B.S. sites, weird sources, “user reported” ones like Wikipedia etc.
I just got the results back from my Cystatin C test and the results aren't encouraging. My +eGfr has dropped to 64 and my Cystatin C level is at 1.17. So that's nearly at 20 point drop in five months from my previous creatinine based test in March which was 82. I'm pretty discouraged at this point as I don't understand what is happening. What could cause so a steep decline in such a short period?
These are very good questions for your nephrologist. My nephrologist LOVED the fact that I was already on metoprolol. Apparently it is very good for your heart if you need it. I started with the nephrologist at CKD 3b. Keeping my BP in line, stopping NSAIDS, switching from omeprazole to famotidine, losing a little weight and drastically lowering my sodium intake has me improving to a CKD 3a.
I’m a medical laboratory professional. Your drop in eGFR and rise in creatinine could be reflective of your hydration status at that time. I am actually surprised at 82 that you could get a referral to an neph and have insurance pay for it. Your neph does need to get to the reason you have low level proteinuria, though. At 3a and 3b, I still do not have proteinuria.
Best of luck and make sure to give us an update. I love to learn more from other people’s journeys.
nearly 15 years at 100 mg twice a day,no other meds other than seizure med during that time.nephrologist said it caused my ckd being on the wrong bp med and dose for so long.
no. they had to put me on a water pill,two new bp meds and vit d before my egfr went back up.im currently on lipitor and jardience and seeing both cardiology and lung doc.
Hope you are doing good. You will be fine your numbers are still good. But did you ever measure how much protein in urine? And what dosage and for how long were you on PPI’s?. I had the same issue with PPI i developed extremely foamy urine which turned out to be trace or 1+ of protein I leak. And when I did 24 hours urine check. It’s about 120-150 mg of protein which is the upper limit and creatinine is fluctuating between 1.1-1.2 for 2 years now. My advice is to stop ppi. All the best
I did a test in Oct 21 (24 hour urine) and it was actually showing as normal. However, I have had the foamy urine since about 2017. My "stick" rate is trace and my 24 hour urine from Oct 2021 was 123. Creatinine in Mar of this year was 1.07. I haven't had a repeat of the creatinine test just the cystatin c.
When I first was prescribed PPIs I was taking 60mg of Dexilant daily for a few years. At one point I was having some strange joint issues so I went to over the counter 20mg prilosec. The last PPIs I was taking regularly was 20mg nexium.
Unfortunately, because my lab work from March of this year didn't make it to me, I started a course of about two months on the nexium again because of ongoing nausea issues.
I sent over the Cystatin C results to Mayo Clinic and requested and earlier appointment and they accomodated me. I'll be seeing the nephro this next Wednesday.
I think you should start getting natural stuff, start working on your digestive problems, get some probiotics, read about the relationship of probiotics and creatinine levels, some of them bring down creatinine, you should get some aloe Vera from the natural stuff to fix the reflux problem and yogurt in the morning, after that follow your diet, and get as many vitamins as you can, and this will be for long time, so you can let your body heal, try to look for some Chinese herbs that controls de blood pressure, this is my opinion based on experiences
As all the physician supported CKD site recommend, if you decide to supplement know that there are numerous studies available detailing the overall ineffectiveness of supplements and CKD. There is no science supporting benefits of nutritional supplements…
The supplement industry is one of (IMHO) greatest cons pulled on an unsuspecting and unwilling to research American public…pick any thread on the site and you’ll see the benefits of supplements being touted but there is no empirical evidence…my opinion as a 30 year (so far) survivor living with stage 4 CKD eat a nutritional but balanced diet…reduce protein as advised by a trusted medical provider and eat as you have a long-term somewhat life altering but not life changing chronic condition and see a medical professional you trust…there is no science. Until the scientific evidence is empirically established and proven that nutritional supplementation or supplements have beneficial effects for the average CKD sufferer such changes are not harmful but not necessary either…use common sense and eat well not like the average American! Just IMHO! My best to you!
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