Question:

I am a 46 years male person,suffering from hypertension,anxiety,tachycardia and hyperlipidimia since 2006. I am under treatment of a cardiologist since then. My echocardiography was done twice ,in 2009 and in 2013.

in the year 2014, prostate enlargement has been detected.Several tests were done and as per advice of urologist,i am taking flotral 10 mg since then.

after long time sitting, lower legs feel tight.when i walk rapidly for 1 hour,my fingers become tight.



on 5.5.2017,i noticed swelling of both ankles and feets.dimple was formed there after putting pressure.My House physician told me to make routine urine test and albumine -creatinine ratio.First test came normal but ACR value became 28.2. Doctor told me to stop Sartel and to start cilnidipine 10 mg.He also stated to repeat those two tests after 3 months. I stopped all medicines till today and noticed that all complications including swelling disappeared. Now, I would like to ask Dr. Rabi Bansal,Nephrologist,:

1) why my ACR values are on increasing trend? 4.6 in 2013,14.6 in 2014,28.2 in 2017 - does it indicate onset of kidney failure?



2) my doctor said,telmisartan is responsible.Is it true? If so, then is it possible the ACR value will return to lower value after withdrawl of telmisartan?




present medication : Up to 5.5.2017 : sartel 20,rosavel 10,concorcor 1.25, fotral 10.

From 6.5.2017 till date : i have stopped all medicines.

Basic informations : height - 5 ft.9 inch , weight - 80 kg , B.M.I. - 26 ,non smoker,non alcoholic

age - 46 years, allergy in sulpha drugs.




I measure B.P. once in a week for past 5 years and it ranges from 120 - 130 / 80 - 86. my urine frequency is normal,apettite is normal.

Dr.Bansal I have attached current spot urine albumine creatinine ratio and routine urine examination ratio.both test were done on may,2017.Only,KUB report is old.i don't know whether you have received these two tests report or not...

Dr. bansal,as i could not attach more than three test reports along with my questions,hence i did e-mail to " YYYY@YYYY " my details case history and attached 20 test reports.But perhaps that mail could not reach to you for some unknown reason.However,I am sending an e-mail once again to " YYYY@YYYY " from " YYYY@YYYY " for your kind consideration.Please explain the situation as revealed from these repots.

I am a 46 years male person,suffering from hypertension,anxiety,tachycardia and hyperlipidimia since 2006. I am under treatment of a cardiologist since then. My echocardiography was done twice ,in 2009 and in 2013.
in the year 2014, prostate enlargement has been detected.Several tests were done and as per advice of urologist,i am taking flotral 10 mg since then.
after long time sitting, lower legs feel tight.when i walk rapidly for 1 hour,my fingers become tight.

on 5.5.2017,i noticed swelling of both ankles and feets.dimple was formed there after putting pressure.My House physician told me to make routine urine test and albumine -creatinine ratio.First test came normal but ACR value became 28.2. Doctor told me to stop Sartel and to start cilnidipine 10 mg.He also stated to repeat those two tests after 3 months. I stopped all medicines till today and noticed that all complications including swelling disappeared. Now,my questions are:
1) why my ACR values are on increasing trend? 4.6 in 2013,14.6 in 2014,28.2 in 2017 - does it indicate onset of kidney failure?
2) my doctor said,telmisartan is responsible.Is it true? If so, then is it possible the ACR value will return to lower value after withdrawl of telmisartan?

present medication : Up to 5.5.2017 : sartel 20,rosavel 10,concorcor 1.25, fotral 10.
From 6.5.2017 till date : i have stopped all medicines.
Basic informations : height - 5 ft.9 inch , weight - 80 kg , B.M.I. - 26 ,non smoker,non alcoholic
age - 46 years, allergy in sulpha drugs.

I measure B.P. once in a week for past 5 years and it ranges from 120 - 130 / 80 - 86. my urine frequency is normal,apettite is normal.

I am a 46 years male person,suffering from hypertension,anxiety,tachycardia and hyperlipidimia since 2006. I am under treatment of a cardiologist since then. My echocardiography was done twice ,in 2009 and in 2013.
in the year 2014, prostate enlargement has been detected.Several tests were done and as per advice of urologist,i am taking flotral 10 mg since then.
after long time sitting, lower legs feel tight.when i walk rapidly for 1 hour,my fingers become tight.

on 5.5.2017,i noticed swelling of both ankles and feets.dimple was formed there after putting pressure.My House physician told me to make routine urine test and albumine -creatinine ratio.First test came normal but ACR value became 28.2. Doctor told me to stop Sartel and to start cilnidipine 10 mg.He also stated to repeat those two tests after 3 months. I stopped all medicines till today and noticed that all complications including swelling disappeared. Now,my questions are:
1) why my ACR values are on increasing trend? 4.6 in 2013,14.6 in 2014,28.2 in 2017 - does it indicate onset of kidney failure?
2) my doctor said,telmisartan is responsible.Is it true? If so, then is it possible the ACR value will return to lower value after withdrawl of telmisartan?

present medication : Up to 5.5.2017 : sartel 20,rosavel 10,concorcor 1.25, fotral 10.

my question to Dr.Bansal -
1.Current Usg KUB states Marginal increased renal ecotexture bilaterally -what does it indicate? I am attaching all current reports,please advise me?


I have sent all my details and all reports via e-mail to " YYYY@YYYY " from " YYYY@YYYY " .Please advise me about my next course of action.