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Does Having A Single Kidney Increase Blood Pressure ?
Question: Hi, I am a patient of high blood pressure and 25 years old. It all started like this. I was sufferring from positional vertigo. Vertigo in certain positions of head. I got checked for BP few months back. It was 124/82 one time in emergency. Again after 3 weeks, it was 120/80 in some diff hospital. Next day, a diff doc checked it and it was 145/98. He put me on medication, Ciplar La BD. Then after starting medicaiton, after 4 days since the morning it was feeling heaviness in chest and was having fearful thoughts for almost the whole day. Went to emergency at night, bp was 160/100. After 10 mins wait, it was 150/100. I was given an injection and it came to 120/80 in 20 mins. I was asked to go many tests. 2 ECGs earlier in emergency were normal. Next day, ECG showed probable LVH, right atrial abnormality and some anterior injury. I went echo the same day, it showed everythng normal. Some systolic ejection fraction was 54% which should be 56%. Went to cardiologist and he said everythng is ok with heart. Had renal ultrasounds, showed i have single kidney. Had blood tests for sugar, cholestrol, serume , lipid profile etc and all were normal. In urine routine, protein came high 100mg/dl. Doc said its kidney infection and gave antibiotic for 1 week BD. After that, I had 24 hour protein test it was normal. Since then I had 5 routine urine tests,4 Kidney Function Test all were normal. Doc said i may be having BP from single kidney, and put me on Ciplar LA+Telma OD. My bp started showing low 100/60, sometimes < 100/60. I went to a different doc, he put me on Amtas 5mg, OD. And then one day I had BP of 150/90 and he increased my dosage to 10mg BD. Laster sometime, we and doctor realized that my BP increase happens when I am anxious. Then we reduced dosage and BP continued normal and finally reduced my dosage to 2.5mg, OD. Since then my BP stays around 120-80,130-90. Sometimes, it shows readings < 120/80 and sometimes readings around 140/90. High end readings happen when I am feeling very anxious. I also had my renin level test 1 year which was also normal. Also my bp in doctor's office was 127/70 1.5 months back. In doctor's office, the 1st reading was higher but next reading was 130/80 and 3rd one was 127/70. I have anxiety when I visit doctor because of past experience. Also I monitor my bp daily and it remains within 120-130/80-87 usually. When I am really anxious because of measuring BP, it reaches like 135-140+/80-90. Also 1.5 months back, I had my kidney function test and it was normal. Creatinine, Sodium, Potassium, GFR all were normal. I had my ECG also 1.5 months back and it was also normal. But doctor didn't order urine test 1.5 months back. Now my concern is should I worry for urine test as the last I had was 9 months ago as in the 1st urine routine test I had, I had protein level of 1+ but 5-6 urine tests after that ( in a span of 6 months) and 24 protein urine test after that was normal. Usually in the morning, I can see that my urine is darker and has bubbles which dissipate soon though but once I start drinking water, my urine remains fine and even when bubbles are formed due to pressure of urination, they dissipate very quickly within 1-2 sec. But since morning urine bubbles take a little time to dissipate, should I get concerned even when KFT was normal 1.5 months back? I drink good amount of water in the day, total around 3.5L water a day. I have this query because I am a hypochondriac which I am sure, you can tell from my query and even though protein scenario happened only the 1st time our of 7-8 times, sometimes I get concerned though things look fine.
Hello Mr XXXXXXX
Thanks for the query.
From the history, it most likely suggests that you have mild Hypertension which appears to be well under control (Going by your current blood pressure readings).
The urine protein detected 9 months back most probably seems to be due to urinary infection. This has resolved now, as mentioned by the repeat urinalysis and 24 hr urine protein which showed normal findings. Hence you need not worry anything about the urine findings and there is no indication for any testing at the moment.
The bubbles in the urine are due to mixing of air during the process of micturition and are completely benign. The morning urine is more concentrated and has minimal amounts of protein which is normally excreted, hence you might find it to be more frothy. This is also benign issue and does not need any intervention.
Ultimately most of your concerns are very benign. But you may need help to manage your anxiety. Hence you might consult a psychiatrist or your primary doctor who can prescribe you a course of anxiolytic medications (Alprazolam, or lorazepam). In addition behavior modification techniques will also be suggested by him which will help you feel calm, more relaxed and happy.
I hope this helps.
In case any more doubts, I am available for the follow ups.
Regards.
Dr Anvekar.
Thanks for the query.
From the history, it most likely suggests that you have mild Hypertension which appears to be well under control (Going by your current blood pressure readings).
The urine protein detected 9 months back most probably seems to be due to urinary infection. This has resolved now, as mentioned by the repeat urinalysis and 24 hr urine protein which showed normal findings. Hence you need not worry anything about the urine findings and there is no indication for any testing at the moment.
The bubbles in the urine are due to mixing of air during the process of micturition and are completely benign. The morning urine is more concentrated and has minimal amounts of protein which is normally excreted, hence you might find it to be more frothy. This is also benign issue and does not need any intervention.
Ultimately most of your concerns are very benign. But you may need help to manage your anxiety. Hence you might consult a psychiatrist or your primary doctor who can prescribe you a course of anxiolytic medications (Alprazolam, or lorazepam). In addition behavior modification techniques will also be suggested by him which will help you feel calm, more relaxed and happy.
I hope this helps.
In case any more doubts, I am available for the follow ups.
Regards.
Dr Anvekar.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi, Thanks for your response. Actually even when I was taking 5mg BD Amlodipine and not eating any salty food and no salt even in regular food, my BP used to be 115-125/80-85 usually and 140+/90 when I was really anxious. Now after 1 year with 2.5mg OD and with normal salt food but no additional table salt over the food, my bp stays 120-130/80-88 usually and 135-140+/90 when I am really anxious. Also, sometimes when I am actually relaxed, I have seen readings like 120/76,115/78, 110/69 also. The problem is whenever I see BP machine and go for measuring BP, I get anxious and then it takes some time to get calm. Otherwise for other parts of the day, I feel fine. 5-6 months back, I used to feel anxiety all the the time and used to measure BP many times and all the day. But since then I am trying to be more disciplined, measuring BP only in the night after dinner and before medicine and not thinking much about BP and stuff. I actually went to a psychiatrist 1 year back and he prescribed heavy medicines but those just made me feel lazy all the time and nothing improved in one month. Then I quit those and tried to be more disciplined and tried not to think about BP all the time and things improved in terms of anxiety. I think I can do better as there is still lot of scope to improve. Also, the most BP readings I take are still with some anxiety and I think I can improve my BP to some extent more once I get more disciplined and if possible get rid of 2.5mg OD but I will do that only when BP consistently remains in 120/80 range as suggested by my white coat hypertension. Also, 1 year back doctor told me to cut back on my protein intake because of single kidney and avoid high protein diet and I stopped taking eggs and similar foods. Can you please suggest me what should be my intake of protein? I eat regular food and after seeing those bubbles I mentioned before, I am trying to make sure that I don't eat more than 50g of protein from various foods in total. Should I be this much cautious? My Primary care doctor here says that eating less protein might not make any difference and I should continue eating normal but not too much protein. About my lifestyle, I don't drink and I am a vegetarian. I try to do cardio 5 days a week for 30 mins each day and yoga once a day for 30 mins. My height is 5'2 and weigh 128lbs.
Hello,
Thanks for the follow up.
Having a single kidney can increase the load on the existing kidney, resulting in high blood pressure, proteinuria, and reduced GFR. But as long as these conditions are under control, they will probably not affect your health or longevity.
Having a single kidney does not mean that you have to follow a special diet. You simply need to make healthy choices, including fruits, vegetables, grains, and low-fat dairy foods.
When eating fruits:
Choose peaches, grapes, pears, cherries, apples, berries, pineapple, plums, tangerines, and watermelon
Limit or avoid oranges and orange juice, nectarines, Kiwis, raisins or other dried fruit, bananas, cantaloupe, honeydew, prunes, and nectarines
When eating vegetables:
Choose broccoli, cabbage, carrots, cauliflower, celery, cucumber, eggplant, XXXXXXX and wax beans, lettuce, onion, peppers, watercress, zucchini, and yellow squash.
Limit or avoid asparagus, avocado, potatoes, tomatoes or tomato sauce, winter squash, pumpkin, avocado, and cooked spinach
Limit your daily salt (sodium) intake to less than 2 grams. Reading nutrition labels on packaged foods to learn how much sodium is in one serving and keeping a sodium diary can help. Limit alcohol and caffeine intake as well.
Avoid high-protein diets. Protein breaks down into the waste materials that the kidneys must remove, so excessive protein puts an extra burden on the kidneys. Eating moderate amounts of protein (1gm per kg body weight) is still important for proper nutrition. In your case, the daily protein requirement would be 58 grams per day.
It is very good, and you are on the right track to manage your anxiety and Hypertension. Though lifestyle changes and medications are important aspects of blood pressure management, the most important is STRESS management.
The main part of stress management is the fact that a person should understand that things change and a person has to adapt to the change. The adaptation may be difficult in case of bad changes but there is no way out, other than to change. Reacting to the situation instead of taking the right action, does not help in anyway rather it complicates the situation.
A person reacts to a stimulus or a thought in different ways.
A anxious person would start running around the place helter skelter thinking that the stimulus is abnormal, even before he gets to know if the stimulus is normal or Abnormal.
A relaxed and thinking person would analyse the stimulus and then decide what steps to be taken in regard to the stimulus.
You have to understand that reaction causes more issues and trouble than doing the actual action to counteract the stimulus. Mind control is based on doing the action rather than reacting.
Since now you are doing all the right things, with regard to diet, medications, regular follow ups which are all forms of ACTION, your anxiety issues (form of REACTION) should subside over time and get controlled. This will ultimately help you to live a healthy and satisfied life.
Some steps that will help to curb your anxiety would be yogasanas, pranayama breathing exercises and having a proper sleep.
I hope this helps.
Regards,
Dr Anvekar.
Thanks for the follow up.
Having a single kidney can increase the load on the existing kidney, resulting in high blood pressure, proteinuria, and reduced GFR. But as long as these conditions are under control, they will probably not affect your health or longevity.
Having a single kidney does not mean that you have to follow a special diet. You simply need to make healthy choices, including fruits, vegetables, grains, and low-fat dairy foods.
When eating fruits:
Choose peaches, grapes, pears, cherries, apples, berries, pineapple, plums, tangerines, and watermelon
Limit or avoid oranges and orange juice, nectarines, Kiwis, raisins or other dried fruit, bananas, cantaloupe, honeydew, prunes, and nectarines
When eating vegetables:
Choose broccoli, cabbage, carrots, cauliflower, celery, cucumber, eggplant, XXXXXXX and wax beans, lettuce, onion, peppers, watercress, zucchini, and yellow squash.
Limit or avoid asparagus, avocado, potatoes, tomatoes or tomato sauce, winter squash, pumpkin, avocado, and cooked spinach
Limit your daily salt (sodium) intake to less than 2 grams. Reading nutrition labels on packaged foods to learn how much sodium is in one serving and keeping a sodium diary can help. Limit alcohol and caffeine intake as well.
Avoid high-protein diets. Protein breaks down into the waste materials that the kidneys must remove, so excessive protein puts an extra burden on the kidneys. Eating moderate amounts of protein (1gm per kg body weight) is still important for proper nutrition. In your case, the daily protein requirement would be 58 grams per day.
It is very good, and you are on the right track to manage your anxiety and Hypertension. Though lifestyle changes and medications are important aspects of blood pressure management, the most important is STRESS management.
The main part of stress management is the fact that a person should understand that things change and a person has to adapt to the change. The adaptation may be difficult in case of bad changes but there is no way out, other than to change. Reacting to the situation instead of taking the right action, does not help in anyway rather it complicates the situation.
A person reacts to a stimulus or a thought in different ways.
A anxious person would start running around the place helter skelter thinking that the stimulus is abnormal, even before he gets to know if the stimulus is normal or Abnormal.
A relaxed and thinking person would analyse the stimulus and then decide what steps to be taken in regard to the stimulus.
You have to understand that reaction causes more issues and trouble than doing the actual action to counteract the stimulus. Mind control is based on doing the action rather than reacting.
Since now you are doing all the right things, with regard to diet, medications, regular follow ups which are all forms of ACTION, your anxiety issues (form of REACTION) should subside over time and get controlled. This will ultimately help you to live a healthy and satisfied life.
Some steps that will help to curb your anxiety would be yogasanas, pranayama breathing exercises and having a proper sleep.
I hope this helps.
Regards,
Dr Anvekar.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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