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Dr. Andrew Rynne

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Exp 50 years

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Normotensive, NIDDM, high serum creatinine, taking BP, diabetes medicines to delay renal disease, BP not getting lowered further. Advise?

Dr. Shantharam, I am 53 yrs. old male Normotensive but suffering with NIDDM since 1987. BMI is 21. Incidentally the Serum Creatinine was detected to be 1.9 in the year 1995. (Case of Diabetic Nephropathy was excluded). Since then periodic renal function checking is being done. Now the Sr. Creatinine level is varying from 1.9 to 2.2. The Maintained BP is 130/80 mmHg. To delay the progression of the renal disease I have been asked to keep BP less than 125/75 mmHg. So I was taking Telmisertan 80 once for past 5 years. Now I have been advised to add Amlopdipine 2.5 once for past 2 weeks. The BP is not getting lowered further. For controlling the diabetes I am taking Gliclazide 80, 3 tablets per day. Kindly advise to protect my renal function from further deterioration. With best Regards, RK Saha Durgapur, West Bengal, India.
Fri, 17 Aug 2012
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Internal Medicine Specialist 's  Response
You are diabetic for almost 25 years and renal involvement in 1995 ,renal functions are compromised but yes progression of nephropathy can be reduced but may not be stopped, we need to know albumin in urine if positive protein in 24 hour urine may be required ,kidney size by ultrasound examination is advised.You also need to keep check on blood pressure ,also check sodium,potassium,calcium and phosphorus in blood and treat accordingly vitamin D supplimentation may be required. Diuretic like Dytor or Lasix may be used . See a Nephrologist.
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