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Renal patient and diabetic. On CAPD, insulin and taking cardvas, flavidon and lanum. Have high BP and cretinine

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Practicing since : 2006
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53 yrs old, renal patient on CAPD, diabetc history 28 yrs, currently on insulin 30/70-=25 units, HT for >18 yrs, taking
cardvas 6.25mg 1-0-1
nicorandil 5 mg-1-0-1,
cilacor 10 mg1-0-1
, t carloc5 mg1-0-1
minipress xl 5mg 1-0-1
aturva 19 ng 1-0-1
clopitab 75 1-0-1
flavidon 25 mg 1-0-1
lanum 10-0
Current out put 500 ml urine, 1100 fluid thr'CAPd, direct fluid consumption 1.2-1.4 litres
creatinine 6.8, urea 60, all electrolytes under cotrol, glycosilated Hg=8, sugar fasting up to 130, pp 170-190
leep apnea
BP systolic 150-180, diatolic 85-95, high BP with low salt intae not helping,
oedema by evening in the legs
Pl advise
Posted Sun, 4 Aug 2013 in General Health
Answered by Dr. Basheer Ahamed 5 hours later

Welcome to XXXXXXX Thanks for your query.

Your Diabetes based on the above given values is quite controlled.

You need to preferably maintain the HbA1c level below 7 %.

You have comorbid illness that has caused damage to your kidney.

Now you have Chronic kidney disease due to Diabetes and Hypertension( Diabetic and Hypertensive Nephropathy).

Serum creatinine levels are very high.

This is causing you pedal edema(Leg swelling) and raise in the blood pressure.

You need to follow.

1. Tight control of blood sugar.

2. Low salt and protein intake.

3. Control of hypertension

4. Dialysis

Consult a Nephrologist for the treatment of CKD.

Hope the answer helps you.
Pleased to answer other queries.

Above answer was peer-reviewed by
Follow-up: Renal patient and diabetic. On CAPD, insulin and taking cardvas, flavidon and lanum. Have high BP and cretinine 44 minutes later
I now that the answer is well on the predictable lines and not surprising. But, iwa asking for specific advice on HT. Can you not suggest a simple combination of of a fewer no of drugs rather than the long I am prescribed. long list i am prescribed. Further, why new generation angiostein receptors hhave nt been recommended why/ how ystolic BP could be reduced further?
Answered by Dr. Basheer Ahamed 2 hours later

Unlike other patient you can not be prescribed drugs because you have a compromised renal status.

You may need dose adjustment in many antihypertensives.

Without knowing the Creatinine clearance value prescribing overdose may harm your kidneys.

In this forum we can make only recommendations and prescribing drugs are against the policy.

It would be better for you to consult a nephrologist and get all your dose adjusted.

Above answer was peer-reviewed by
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