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Blood Pressure Medication and Renal Impairment

todd121's picture
Posts: 1425
Joined: Dec 2012

My doctor recently put me on a fairly popular blood pressure medication, HCTZ. He selected the lowest dose, 12.5 mg/day. He'd told me that at this dosage it was not diuretic. However, when I started taking it, I definitely felt the effects and my blood tests appeared to show that it had had a diuretic effect (my RBC and other related tests are always borderline/below normal since my kidney was removed, but once I was taking this, they were all in the normal range). I also experienced palpatations.

A search online found this article:


After I talked to my doctor about the palpatations he switched me to a beta blocker instead. I haven't started it yet. I'm a bit more nervous now taking a drug.

I don't really blame my doctor. He's a great family doctor, but most of his patients all have 2 good kidneys, so I'm sure he wasn't aware that he needed to reduce the dosage in patients with mild renal impairment.

I thought this information might be of interest to others here that might be on this medication, since it is a very popular one from what I understand. This is just a reminder to me that I need to do a bit of poking around (looking online, talking to the pharmacist, etc.) just to make sure when I take a new drug where it's metabolized and what effect my lacking two good kidneys will have. (I have to pay special attention, because there's host of drugs you can't take with everolimus, which is another reason for being extra careful.)

Anybody on a beta blocker? What do you think of it? I'm being strongly encouraged by my uncle to get my blood pressure down even if I can't do it through weight loss, he's saying to do it with medication as high BP is hard on the kidneys.

Does anybody know if high blood pressure is particularly hard on the kidneys when you only have one of them?

Thanks and best wishes,


P.S. One of my doctor's patients has recently had a nephrectomy due to kidney cancer and he said the guy is having a hard time. He asked if I would mind if he passed my number to the guy. I'm still evaluating that, whether I like it or not and whether it's a good idea or not. I said sure. My first reaction is to be glad that he's being so thoughtful of this guy and I do think it's helpful to have someone to talk to. The first thing I'll do if he calls is send him here!

Jojo61's picture
Posts: 1310
Joined: Oct 2013

Hi Todd,

I have had high blood pressure for several years, and used medication to control it. About 2 years ago, my blood pressure continued to rise even though I was on meds. The doctor tried several different meds and finally we found one that worked. Since I found out about my tumor, I read about the relation between blood pressure and kidney cancer, and kind of wondered if mh blood pressure rising like that should have been a red flag for th cancer. I will never know. My doctor retired and I now have a young guy. After my nephrctomy he told me to ask the uroncologist if I should continue with the same blood pressure medication....now reading your post, I think it was a really good question. I did ask the uroncologist. He asked me how my blood pressure is with medication. I told him it was normal. He said, then keep it the same.

I am very impressed that your doctor was concerned about the other nephrectomy patient. It can be tough. I think you would be very helpful for this guy.



todd121's picture
Posts: 1425
Joined: Dec 2012

Hi Jojo,

My blood pressure only started getting high in the past 3-4 years and even then was borderline (130's/80's but close to 140/90). Nobody in my family has high blood pressure that I know of. My mom and grandmother on my mom's side have had low blood pressure.

I'm impressed he mentioned the guy too. Actually, I'm still a bit surprised and kind of shocked. With the HIPPA/HIPPA/HIPPO law or whatever it is, they have generally fought giving out even the slightest information to my mom about my sister's healthcare (who needs help, by the way, even though she doesn't think she needs it). Without me signing somethng, I'm surprised he'd do it. But I'm impressed that's not the first thing on his mind...and glad for it really. I think we've gone too far in some ways with this privacy stuff, and not far enough in other ways. For example, they won't tell my mom about my sister's treatment, but I'll bet the information is available to anybody with the dough to pay for it blackmarket or otherwise!

We'll see if he calls me. If he won't come in to see the doctor, he probably won't call me.

Take care.



Posts: 115
Joined: Sep 2013

I have had high blood pressure for quite a few years.   Everyone on the maternal side of my relatives has high blood pressure, aunts, uncles, mother, all cousins.    I used to be on an ACE inhibitor until I developed a bad cough thought to be due to the ACE, though it could have been due to a small pleural effusion. (The pleural effusion started investigations which thankfully discovered my renal tumor.)   In any case, I was having palpitations on occasion and palpitations  so my cardiologist started me on metoprolol.   I am very happy with that because it not only controlled my blood pressure but also the palpitations (rarely have them now) and also controlled a higher than normal pulse.   I just have one kidney and I don't want high blood pressure to damage it, trying to protect it as much as possible.  On occasion my blood pressure is a little higher than I would like and I will take 2.5 mg of lopressor.   I am trying to keep BP well under 120/80 as much as possible.  

I was started on HCTZ at one point along with the ACE and it dropped my blood pressure so much that I had to stop the HCTZ.

I used to have some swelling in my legs, but since having a total nephrectomy, I RARELY have any fluid retention.


Frank302's picture
Posts: 71
Joined: Feb 2013

I've had high blood pressure for a long time and have had a lot of difficulty finding any meds to bring it down . I'm alergic to beta blockers . They cause me to have violent asthma attacks . I'm seeing a new doctor now and started some new meds that are looking promising .

Now that I've had kidney cancer I wonder if high blood pressure had a part in it . Probably .

donna_lee's picture
Posts: 955
Joined: Feb 2009

The practicing physician (with an emphasis on practicing) I had from 2003-2005 watched my BP go up each year when I went for my annual check up.  He ordered no extra blood work or a urinalysis.  In 2006, the new PC (Primary this time-and very thorough) read me the riot act, also ordered a urinalysis with the physical, blood work plus an ultrasound.  That's what found the cancer.  

He's been very pro-active and put me on an ACE inhibitor and Simvistatin for cholesterol.  Later, he atted a beta blocker.  We've tinkered with the dosages on all 3 over the past 7 years to get it to level out.  I look at the overall picture; before the CT last week it was 110/80; yesterday in the office it was 143/78.

I don't think the high blood pressure causes cancer, but it can contribute to an overall non-healthy status, which makes an opportunistic disease more likely to develop.

Have to "brag" about my PC.  He spent 14 years in the Army and was a Special Forces Medical Seargent working with the Kurds in Northern Iraq during Desert Storm. When he got out of the Army, he applied to Delta Force and Medical School and decided he'd go with whichever accepted him first.  Good thing, too, or I probably wouldn't be here to write this.  If you need a PC with a gentle bedside manner, look somewhere else.  But we get along great.


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