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Sudden increase in BP. Hypertensive, diabetic. Could it be blockage in renal flow ?

Hi ,
My father is 68 years old, having Hypertension since he was 30 years and also diabetic since last 9 years.. His blood pressure shot up to 230/130 yesterday. His blood work shows today Creatnine 1.8, Uric Acid 9.2 and Urea 72 and ESR shows 29. Doctor is thinking of blockage in renal flow and asked to do Would like to know how critical it is show a nephrologist. As of now we are visiting an MD.
Asked On : Tue, 2 Apr 2013
Answers:  3 Views:  39
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Internal Medicine Specialist 's  Response

Thanks for posting query.

Sudden rise in blood pressure up to 230/130 usually suggests hypertension due to secondary cause like renal artery stenosis,phechromocytoma,aortic dissection etc.But here in your father's case it something different.

He is known case of hypertension since last 30 years and also diabetic since last 9 years.Hypertension and diabetes both can cause decrease in renal function if not adequately treated.Hence rise in creatinine,uric acid and blood urea can be due to uncontrolled diabetes and hypertension.Also sudden rise in blood pressure up to 230/130 can be due to non-compliance to anti-hypertensive medicines or inadequate treatment.

Though the possibility of renal artery stenosis is less I would like to suggest to tests Urine for proteinuria ,USG-KUB and renal doppler study that will help for definitive diagnosis.

Hope this will help you to clear you doubts.

Wish you good health.
Answered: Wed, 3 Apr 2013
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
High blood pressure and uncontrolled diabetes in longer run tend to cause damage to the kidney functions and the reports of high creatinine and high urea are suggesting that.
You must definitely consult a nephrologist and get further investigations likeĀ 
Creatinine clearance,urine osmoloality ,24 hour urine protein estimation etc done to assess the functions of kidney and look for the signs and staging of the chronic kidney disease done,so that a proper treatment plan can be formulated to prevent your father from going into end stage renal disease.
A prompt treatment at the moment can slow the progression of kidney damage.
His blood pressure and sugar levels must be meticulously controlled to slow the progression of damage.
His blood pressure of 230/130 is very high and needs urgent control.
Answered: Wed, 3 Apr 2013
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

He MUST be seen by a soon as possible.
He has Early Chronic Renal Failure...also some pre-renal component...
It is due to Hypertension and Diabetes.
It is unlikely to recover completely / but can be made stable or the progression slowed with the help of Nephrologist...
Strict control of pressure and sugar are needed /

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Tue, 30 Apr 2013
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