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High BP, creatinine levels. Prescribed envas medication. Renal biopsy required?

My wife aged 33 ..had high BP during May 2012 and as per family doctor s advise she took Envas2.5mg (one time in the morning) and we went to Apollo last week and doctors suggested to take Stamlo2.5. Her both kidney size are per report the thickness is 0.47 & 0.48 for this reason we are not able proceed with renal biopsy . Her creatinine level 3.1
Asked On : Fri, 31 Aug 2012
Answers:  2 Views:  256
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Internal Medicine Specialist 's  Response
Jan 2013
Thanks for posting your query.
Is she undergone ultrasound imaging of kidneys? What was the reports?
What was the size of kidney in ultrasound imaging? Is cortico-medullary differentiation maintained or not?
Raised creatinine may be due to acute renal failure (ARF) or chronic kidney disease (CKD).
By ultrasound imaging and urine analysis, CKD and ARF can be differentiated.
You should consult with physician/ nephrologist and should follow diet plans.
You should also take prescribed medicines as CKD is associated with multiple complications.
Medicines in CKD are advised to live smooth life.
CKD are generally associated with rise in hypertension (as in your wife case).
Is there any rise in blood sugar?
Diabetes and hypertension are the 2 most common disease worldwide for renal failure.
Keep watch on serum creatinine level.
Regarding medication for blood pressure, you can go stamlo 2.5 while Envas is generally not given if creatinine is > 2.5 (as in your wife case).
You should go for renal biopsy if the cause of renal failure is not clear.
Take Care,
Dr. Mayank Bhargava
Answered: Fri, 31 Aug 2012
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Diabetologist Dr. Madhuri Patil's  Response
Aug 2012
Dear VYaasraj,

Having some kind of disturbance in renal function and hence causing high BP is certainly a reason for a Nephrologist to suggest for renal biopsy. If your wife has had uncontrolled BP since many years and that is the cause of the kidney failure then it is obvious and no need to go for renal biopsy and the same thing for chronic diabetic kidney disease. But if the high BP itself is due to kidney problem, then it is very much essential that the cause for kidney problem is looked for through renal biopsy as, unfortunately, other modalities like simple urine routine and microscopic exam or ultrasound have very limited usefullness to further diagnose the reason. Hence pl follow your Nephrologist and get the renal biopsy done as it might lead to some diagnosis which might be 100% curable or which can be controlled better with specific medications to avoid further loss of kidney functions and need of dialysis and/ or kidney transplant. Having normal size kidneys in the ultrasound is another thing which suggests you must go ahead for the renal biopsy. So all the best. Do revert back for any further queries.
Answered: Fri, 31 Aug 2012
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