low BP on dialysis

[mingmiley]

I've been on dialysis 9 years, my BP WAS FINE all these years, even little bit of on the high side, until this couple years that my BP ALL OF SUDDEN WENT TO THE low side, like 100 over 55 all the time, some times it interfered with my dialysis, I mean I couldn't pull as much as I suppose to. I have been taking little bit of heart med Covedilol, it lowered my BPtoo, We keep cutting the strength of this med from 10mg to 5mg to now 2.5mg, I took that because years ago I had congestive heart failure, so I can't stop it, this med suppose to make my heart stronger. I don't know what to do?

[Jayhawker]

I’m not on dialysis yet but I have had real issues with low blood pressure as well as sudden drops in blood pressure. These BP drops would happen 4-5 times daily with my BP dropping from 100/60 (approximately) to 60/40. I never fainted. But I certainly felt very poorly when my BP would drop suddenly. And, since my BP ran so low all the time (systolic from 90-100 and diastolic 58-64), I felt rather poorly most of the time.

My nephrologists first pulled me off my BP medication. That stopped the sudden drops in my BP. They then discontinued the diuretic I had been taking (furosemide). That raised my BP. It now runs from 111-124 over 65-74. So it is sometimes slightly elevated. It is also more variable. If I have any fluid retention, which is fairly rare for me at this point, it will elevate more.

However, considering my creatinine is 3.09 with an eGFR of 15, my BP data is actually looking pretty good, especially as this is without medication support.

Obviously since I’m not a physician I wouldn’t try to give you medical advice. But I would encourage you to visit with your nephrologist. And, you may find it helpful to see a different nephrologist or a cardiologist who specializes in renal-related cardiac conditions. It took three different nephrologists to get my BP to this point. Each one tried something different. Across all three we gradually got this figured out for me for the time being.

Marj

[mingmiley in reply to Jayhawker]

i'm glad you got some good doctors they responded to you and adjusted your med. I and my Cardiologist are reluctant to stop totally the BP med because the Carvedilol is also my heart med. Your 3.09 creatinine sounds not too bad, giving a low protein, low or no salt diet and try not to catch cold in winter times, it will give you more time to last until dialysis or not. Thank you for your responding, I will pray for your kidneys. Dear Lord, Please preserve Jayhawker's kidneys, help her to take care of it according to good knowledge and Your mercy and kindness. We thank You, In Jesus name we pray, Amen.

[cs65 NKF Ambassador]

I would get your nephrologist and cardiologist talking together. I also took carvedilol after i had stress related cardiomyopathy a couple years ago. I was on the lowest dose because it caused low blood pressure. I finally had to stop taking it after talking to my cardiologist about the problem and after I was fully recovered. I also went to cardiac rehab to strengthen my heart. Now I don't take any blood pressure medicine, but I do take midodrine to improve my blood pressure about midway during dialysis. Don't give up - there are solutions!

[mingmiley in reply to cs65]

Thanks for your experience, it gives me hope. the reason that me and my Cardiologist afraid to totally stop my carvedilol is because we worry that the congestive heart failure might come back. I will continue to wait and see, hope THE 2.5 MG Carvedilol won't affect my heart function. Thank you for sharing.

[mhawk123]

I feel for you as I had the similar problem with my blood pressure running differently with the dialysis. I had serious talk with my nephrologist and we opt to change the solution I was using during dialysis ( home PD), which may a difference in everything. I could tolerate so much more. So have that deep talk with your nephrologist and see if he can recommend the best viable option for you....

[mingmiley]

Before I do Hemodialysis, I tried PD, at that time I was suffering mental illness and was not on med yet so learning to doing it myself at home has become too much, I became extremely anxious I called PD nurse probably ten times a day so she decided I didn't fit for PD, and had me come to in center dialysis.I feel no matter HEMO or PD, I can't handle it all by myself, I'm more used to in-center, have other people around me. i'm 69 now, so taking on PD by myself, i don't know if it will be too much for me. I think I need a community. But we'll see, maybe one day things will change, will see how good Lord will lead me. thank you for writing me back.

[Jayhawker in reply to mingmiley]

I live alone too. I am the last person living in my family. This can definitely be hard to manage alone. So I can understand why you may feel more comfortable with a community around you as you finalize. Certainly in home dialysis options aren’t best for everyone.

Other than your blood pressure issues during dialysis, how do you feel between HD dialysis sessions?

Marj

[mingmiley in reply to Jayhawker]

Hi, Dear Marj, I felt good the next day following dialysis day, I dialysis on Tue, Thur,Sat, usually the next day feels good, but after Sat there's two days off, usually the second day off (Mon) I started not feeling so good until Tue had to go in again. so in weekend i should be careful not to eat much, drink much. but sometimes I failed. It's good that you can do PD, keep as long as you can. Sorry, there are some grammar errors in my writing, I just came home a couple of hours ago from treatment so I'm kind of not together. Thank you for writing back, Have a nice sleep.

[mingmiley in reply to Jayhawker]

My apology, you not on any dialysis, my bad.

[Jayhawker in reply to mingmiley]

No problem🐶 I’m definitely very close to dialysis at this point.

I’m glad to hear that you feel reasonably well the day after HD dialysis.

Marj

[vimrogers]

I am currently on a cardiac ward came in with a sickness bug and dehydration my blood pressure keeps dropping so much so that it went as low as 70/29 they have been giving me saline to raise it only managed to do 2 hours on dialysis instead of 4 hours it seems to be coming back up as I have a bit more flued. You may have put weight on and move your dry weight up, extra water on board will increase your blood pressure.

[mingmiley in reply to vimrogers]

Wow, your BP dropped even lower than mine, hope your sickness bug can be controlled by med, my dialysis friend contracted C-DEFF bug in hospital, that gave her uncontrolled diarrhea, as she went back in the hospital for diarrhea, they used morphine and sedation on her, that led to her unconsciousness and death. Sorry shouldn't be said these, but I hope your doc will take good care of you, make your BP come a certain degree that you can continue to do dialysis, best yet, maybe you will get a transplant, God bless! My doc raised one KL of my dry weight, and cut down half of my heart med ( BP med), also, I have to be careful not to eat a full meal before I come to dialysis Thank you for your writing!

[vimrogers in reply to mingmiley]

I like to look at all options and I think I have caught something like c-dif but, I am home know no has come up to 144/82 so tats better had a better dialysis too managed 4 hours an cleared 85 litres so hopefully that’s ok too. I am still suffering with the diarrhoea which makes me think it is a virus in my bowel. Hope your feeling a little better too .

[mingmiley in reply to vimrogers]

If it's C-DEFF your doc should tell you, but I hope it's not, hope things will be alright.

[mingmiley in reply to vimrogers]

Sorry I didn't know you 've been through so much-4 transplants! I've been through one transplant, it lasted 16 years, I was thinking about the second one, but my antibody was so high, they talked about desensitize it, and then they told me because my age they can't give me the " good kidney", have to be the kidney of somebody had some health problems. Also, I had to still use prednisone because of the high antibody, the prednisone during my first transplant messed up my brain, made my mental state worse, that's why I don't like prednisone. I want a clear mind. I just put myself before the Lord, looking for His mercy and care. I also have osteoporosis, I've been given prolia injection every 6 months., You have been through a lot in this battlefield, put your faith in Jesus, whether live or die we are the Lord's.

[vimrogers in reply to mingmiley]

I know that many people get comfort from different religion s and also helps them in many ways. Unfortunately I am a none believer and what ever happens just happens. I find that my own kick in the pants sometimes is what gets me back fighting. That’s just my way and anyone that has faith in there way of life is great it means they have found there own coping mechanism.

I have had renal failure for 45 years and have learnt so much about my health and am still learning now, I hope that you are feeling a little better too as it will alway test you just make sure it never breaks you and you will be fine.