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Dr. Andrew Rynne

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Suggest treatment for high BP while suffering from kidney disease

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Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4361 Questions

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Posted on Mon, 26 Oct 2015 in Kidney Conditions
Question: This question is for my cousin -

she is having high BP sometimes 180/120 and also found from the tests that there is some kidney disease as well. I have reports of some tests - urine tests (creatinine ), biopsy and so on -attached them . She was prescribed : 1..clindipine 10mg ,2.. sodium bicarbonate 500 mg , 3..Atorvastatin(10mg)+Ezetimibe(10mg)

The doctor told that biopsy only will reveal the reason -We had biopsy done and attaching that report also

Questions :
1. How severe is this - meaning stage of kidney disease ?
2. Apart from continuing on the medication - is there anything else that I can do - any procedures ?
3.Does the kidney disease start abruptly or its there for some time and we are just ignoring the symptoms
4. What is the chance of life threatening consequences like heart attack and death

I would like to get a realistic picture so we can take necessary steps like bringing her to US for better treatment - currently she is in XXXXXXX
doctor
Answered by Dr. Rakesh Madhyastha 26 hours later
Brief Answer:
Immediate intervention required

Detailed Answer:
Hello

Thanks for the query


I have gone through the reports attached by you

Here are the answers to your questions

1. It is quite severe and requires immediate intervention in the form of steroids and cyclophosphamide
2. You can approach a nephrologist and ask them about giving them pulse methylprednisolone and cyclophosamide therpay for several of the nephritis
3. This particular kidney disease has started abruptly
4. There is minimal chances of heart attack however if not treated there can be permanent damage to the kidney requiring dialysis

I hope I was of help, if you have any further queries please get back to me

Regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Rakesh Madhyastha 12 hours later
Thank you Dr XXXXXXX for the good help .

Technically what Stage is the Kidney Disease ?

Also In these cases are there any foods to avoid/consume less ?

Thanks Again

doctor
Answered by Dr. Rakesh Madhyastha 11 hours later
Brief Answer:
Stage can't be determined

Detailed Answer:
Hello

Thanks for the kind words. Stage of kidney disease can be defined only once it's a proven to be chronic, however in this case it's acute and there will be reversibility once treated.

However based on the creatinine both the kidneys are working at half its original function.

I recommend the following diet

1. low salt diet. Avoid salty food like papad, pickle, butter milk
2. low potassium diet. Avoid fruits, fruit juices and tender coconut diet. Avoid raagi
3. avoid red meat

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rakesh Madhyastha 9 hours later
That is very useful information regarding creatinine level vs kidney functioning

just one more question - how do we know its sudden vs existing since long time - if I am right acute vs chronic - are there any thing in the reports thats suggesting that


Thanks again
doctor
Answered by Dr. Rakesh Madhyastha 32 hours later
Brief Answer:
Sudden vs existing

Detailed Answer:
Hello

Thanks for getting back

We know chronicity through the following aspects

1. Raised creatinine for more than 3 months
2. Small kidney size on ultra sound
3. Low calcium, high phosphorus and anemia


There is nothing in the report to suggest established chronic kidney disease

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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