Blood Pressure Medications
Before my kidney cancer, I was told that my weight made it likely I was going to have blood pressure issues "soon". My blood pressure was actually pretty good even though I was overweight before the surgery. It was generally in the 120's/high 70's range. Since my kidney was removed, my BP has gone up some and so now everytime I'm in a doctor's office they want to lower my blood pressure with medication to protect my only kidney. (When I say "they", I mean my nephrologist or or primary care doctor).
My family doctor tried me on hydroclorothiazide (something like that first), a diuretic. It made me feel like crap and I started having a feeling like my heart was racing. So they stopped that. Then they put me on metropolol, a low dose. It didn't have much effect on my BP, so they increased the dose (I can't remember the dosages, either it was 25mg to start with then to 50mg or 50 then to 100). I was having issues with my hands swelling for no apparent reason, feeling anxious like my heart was pumping to hard/fast (even though my heart rate had gone down while I was on the drug), and one day I ended up going to the emergency room thinking I had a heart attack. It did work as far as lowering my blood pressure was concerned. By the way, it did not help libido and seemed to make me gain a little weight (which makes sense, because it lowers your heart rate along with your BP).
I tried to go off it on my own, and my heart raced like crazy the day I skipped my dose. Then I found out you're not supposed to just stop it. That you can actually have a really bad event (I can't remember if it was stroke or heart attack) if you stop suddenly. So, I went back on it. Then I weaned myself off it. My hand swelling problem seemed to go away. However, it turns out it didn't. It's still happening, but less often.
I saw a new nephrologist today. My old one retired. I really miss him. He was great. The new one is a young lady. Very smart. She's worried about my one kidney and wants to protect it. She says at my age and with my health, and my reduced kidney function, I have a good chance of outliving this kidney and needing dialysis so I really should do something to keep my BP down. Normally my BP is in the 130's/85 range, but sometimes it spikes up in low 140/90, or even 150/90, but rarely this last number. Today in the doc office it was 142/92.
I talked to the doctor and did some reading, and I'm having trouble really telling for sure if the doctor's have even figured out positively if high BP causes kidney damage, or if kidney damage causes high BP. I have a feeling they don't know which causes which. (Anybody feel free to chime in here if you know and can point me to scientific evidence.)
The new BP medicine she wants me to take is lisinopril. It's an ACE inhibitor. Now it's making me a little nervous that this drug can cause slight decreases in kidney function "at first" (she says) but in the long run it's supposed to protect the kidneys. When I read around about it, I saw that it can actually cause decrease kidney function and/or increased potassium levels. The doc does want me to come in after a week to have these checked.
Now how does something that decreases kidney function protect the kidneys? I'm not sure how they know that, or if they even know that....
Are any of you guys taking this drug? Did it help your BP? Do you remember what effect it had on your creatinine levels?
I read somewhere online that 20-30% increase in creatinine was considered ok. My creatinine is about 1.7-1.8 right now. So I'm guessing it'd be ok to have my creatinine go up to 2.3. That makes me pretty uncomfortable.
Does anybody know what creatinine levels need to be before you need dialysis? I have no idea how far 2 or 2.5 is from being kidney failure. I know lots of folks on here have 1 kidney and are under 1.5 (which is normal even for 2 kidneys).
I asked the nephrologist if a BP of 140/90 is even harder on 1 kidney than on 2. She seemed to think it was, but actually I didn't get a great feeling that she really knew the answer to that question. She did say that with 1 of my kidneys gone, the total number of nephrons doing the job was reduced by half at least and that that means my other kidney is having to work twice as hard as before to do the same job, so she thinks I'm at greater risk for "wearing this kidney out". I can imagine that, but is a kidney different than a muscle and does it not get better with exercise?
Thanks for listening to my rant about kidneys, BP, and having only 1. I'm just not sure if I'm going to take this drug tomorrow. There's a rare side effect where it causes swelling in the throat and face that requires hospitalization (and they have to insert a tube so you can breathe). Now that one scares me. I feel like I'm playing Russian roulette with my health when I take some of these pills. I guess the good news is there are like 100,000 empty chambers and only 5 bullets in the case of this particular problem. I just hope the benefit is worth the risk. I wish my doctor convinced me that she really knew the benefit would be worth the risk. When she said "the theory is...", that didn't give me great confidence. I don't want to take potentially dangerous drugs based on theories!
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