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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Chronic Kidney Disease And High BP?

Hi i am 65 years old i have a problem of ckd and high blood pressure as directed by Dr i am having these medicines (moxovas 0.3,tolo xr 50,sevcar400,dytor40,trinerve Lc,carnifer,cilacar10,rosuvit cv5,febuget40, now from 2,3 days my bloods pressure is getting low so what should i do at this time
Mon, 27 Apr 2015
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Diabetologist 's  Response
Hi,
Chronic Kidney Disease (CKD) is due to persistant underlying disease like diabetes, uncontrolled high blood presure, untreated kidney stones, rarely it may develop as a consequance to AKI (Acute Kidney Injury).

Treatment of CKD is to prevent or to slow the process of deterioration of kidney function.
It requires-
1) Diet with adequate vegeterian proteins.
2) Control of Diabetes, blood pressure, cholesterol.
3) Avoidance of nephrotoxic food and medicines like pain killers
4) Water intake needs to restrict if there is tendancy to retain water.
5) Low Potassium intake (avoid intake of fruit and fruit juices, coconut water) in case there is potassium retention in body.
6) Maintain calcium, phosphorus, uric acid levels under contol.
7) Avoid smoking, alcohol.
8) Screnning for comlication on heart.

Usually CKD associated with high blood pressure that requires multiple medicines to control.

Development of low BP in patients of CKD with Hypertension indicate-
1) Further deterioration of kidney function which leads to accumulation of drug for a longer in body due to decreased clearance by kidney.
2) Overdosing of medicines.
3) Development of Autonomic neuropathy as a comlication of CKD its self or its underlying cause like diabetes, hypertension.
4) Development of other complications like heart.

So it is advisable you to consult your doctor and get detailed clinical examination and investigations that may help in decision making -
Complete blood count, kidney function test, electrolytes, calcium, phosporus, uric acid, urine examination including 24 hours protein level, ultrasound of kidneys.
Modifiction of medicines is required.

There might be impending Need for Haemodialysis which depends on-
1) Amount of Urine production daily.
2) Serum electrolyte mainly Potassium.
3) Serum Creatinine level.
4) Arterial Blood Gas (ABG) analysis which denote degree of acid accumaulation in blood.
5) Signs of water retention like breathing difficulty, swelling over body, puffiness of face.
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How To Treat Chronic Kidney Disease And High BP?

Hi, Chronic Kidney Disease (CKD) is due to persistant underlying disease like diabetes, uncontrolled high blood presure, untreated kidney stones, rarely it may develop as a consequance to AKI (Acute Kidney Injury). Treatment of CKD is to prevent or to slow the process of deterioration of kidney function. It requires- 1) Diet with adequate vegeterian proteins. 2) Control of Diabetes, blood pressure, cholesterol. 3) Avoidance of nephrotoxic food and medicines like pain killers 4) Water intake needs to restrict if there is tendancy to retain water. 5) Low Potassium intake (avoid intake of fruit and fruit juices, coconut water) in case there is potassium retention in body. 6) Maintain calcium, phosphorus, uric acid levels under contol. 7) Avoid smoking, alcohol. 8) Screnning for comlication on heart. Usually CKD associated with high blood pressure that requires multiple medicines to control. Development of low BP in patients of CKD with Hypertension indicate- 1) Further deterioration of kidney function which leads to accumulation of drug for a longer in body due to decreased clearance by kidney. 2) Overdosing of medicines. 3) Development of Autonomic neuropathy as a comlication of CKD its self or its underlying cause like diabetes, hypertension. 4) Development of other complications like heart. So it is advisable you to consult your doctor and get detailed clinical examination and investigations that may help in decision making - Complete blood count, kidney function test, electrolytes, calcium, phosporus, uric acid, urine examination including 24 hours protein level, ultrasound of kidneys. Modifiction of medicines is required. There might be impending Need for Haemodialysis which depends on- 1) Amount of Urine production daily. 2) Serum electrolyte mainly Potassium. 3) Serum Creatinine level. 4) Arterial Blood Gas (ABG) analysis which denote degree of acid accumaulation in blood. 5) Signs of water retention like breathing difficulty, swelling over body, puffiness of face.