After a radical nephrectomy my eGFR for the remaining kidney is only 28%. I need BP control and take Atenolol and Amlodipine, the hospital stopped Trandolopril and thiazide diuretic due to risk of AKI. Any experience of another effective drug as I need to reduce BP by 15 points?
Hi, i have severe hypertension and take Ramipril and Bisoprolol and they do the trick. My BP was 230/120 and has come down under 140/90, can sometimes go under 120/80 was they both work very well.
Moxonide did the trick for me along with Losartan and Bendrofumiazide. My consultant added Moxonidine and it worked.
Thank you for the reply Richard. I am already taking a Beta Blocker like your Bisoprolol, but Ramipril is an ACE inhibitor and the opinion in hospital was that I should not take these as my kidney function was too poor and they could cause damage to my remaining kidney. I had been taking a similar ACE inhibitor before my kidney was removed and it did control my BP well as you say. So I am looking for something safer. KenR
Ken, I, too, have just a sole kidney, having had one removed over 60 years ago. Ibuprofen caused CKD about 10 years ago and my eGFR is 38 at present. Obviously, so-called kidney-friendly drugs for high BP are the first-line 'go-to' for people such as us. I'm on Losartan Potassium (recently increased from 50 to 100mg daily). Not brilliant at controlling my BP on its own, especially at 50mg so several others have been added over the last 3 years, all of which caused intolerable side effects (some actually causing rapid reduction in eGFR , others reduced sodium levels etc) so all stopped. Hopefully, you won't prove to be as difficult a patient as me (as my renal consultant calls me!). What is your BP at the moment? Atenolol wasn't too much of a problem for me a few years ago but Amlodipine caused me problems with very swollen ankles leading to a diagnosis of varicose eczema. We're all different in how we respond to meds and if one doesn't suit there are others to try. Careful monitoring of kidney function via blood tests is key.
Hi, that is very helpful. Monoxidine looks like a candidate! I was taken off Bendroflumethiazide by the consultants in hospital when my kidney was removed. I do not fancy the possible side effects of Losartan, as I have only 1 poorly functioning kidney.
KenR
Hi, I take atenolol and amlodipine without problems but I need to reduce a bit from 150/90 as prior to kidney removal I was at 130/75. So with eGFR of 28% kidney friendly is my aim and avoiding side effects!
KenR
Lynn, Moxonidine was going to be the next line of attack for me alongside the Losartan that I take but my renal consultant yesterday decided that my body/sole kidney is so sensitive to medications that he is leaving me wher I am on the Losartan alone. I think his decision was also swayed by the fact that all the readings during a couple of days in hospital recently(apart from the one immediately on emergency admission) were within normal guidelines whereas they are usually off the screen at the surgery and the hospital. Likewise when I take them at home. It seems like the answer for me is to be lounging about being waited on all day!
At what level of CKD and eGFR are you, Lynn? Lucky you being able to take three BP meds without problems.
Ken, was your nephrectomy done very recently? If so, I just wonder whether your blood pressure might further improve as your remaining kidney adapts. Having said that reduced kidney function and high blood pressure can go hand-in-hand as they each can be the cause of the other! Is there perhaps something else you can do that might help in lowering your BP, such as taking more exercise, cutting out salt, reducing weight if needed, avoiding coffee and other caffeinated drinks, drinking more water. Also, as you are just into CKD4, could referral to a renal dietitian help?
Hi, maybe we are having crossed lines here! I was thinking that Moxonidine would suit me. I am at level 4 CKD, and 28% eGFR. When and if I get there I will post what I am having,
KenR
I understand, i'm just borderline for Ramipril due to my kidney disease. I'm sure they can address this with alternative medicine.
Hi, the nephrectomy was recent but the eGFR was reducing each time it was measured. I think they booted me out of hospital before the figures looked too uncomfortable, and simply advised no ACE inhibitor or diuretic, but to sort out something with my GP!
KenR
Hello MrsO,
My GFR is 22%. I'm OK except thet my kidneys have stopped making the hormone that stimulates the bone marrow to make red blood cells. Also I now have an aborption problem with moral iron. Therefore I'm on intravenpous iron plus EPO ( the artificial version of the hormone my kidneys no longer make, I think I tolerate all the BP meds I take reasonably well apart from having to take a protein pump inhibitor with them to protecy my gut. I feel lucky as so many pople have problems with BP meds.
Hi Richard,
that is what I am hoping. I find it best to go in fully informed and say what you think might work best. I am not a believer in 'doctor knows best'; with the internet you can be more up to date than they are!
KenR
That is appalling - to think that when I had my nephrectomy all those years ago I was in hospital for 6 weeks! Not surprised though - I've recently spent a couple of days in hospital with a suspected serious infection, according to the Dr in A&E as a direct result of a GP leaving me on a risky antibiotic too long! I was admitted but to compound things, the following day a consultant discharged me all ok, only to receive a phone call from the hospital 3 hours later saying I needed to return and collect a prescription as results were now in and I needed to isolate myself at home for 4 days whilst medicating for 7 days! Hope at least you have a good GP, Ken.
Lynn, it 's good to hear how well you are feeling. As far as the PPIs are concerned, I couldn't take those either when prescribed a few years ago alongside steroids. Instead, I ate a 'live' yoghurt each day before taking the steroids and my stomach/digestive system remained fine throughout my years on the steroids.
Keep being lucky and keep well Lynn.
Hi,
Moxonodine and Amlodopine worked for me, all the others either made me feel horrible or made my bloods go horrible. These two hand in hand worked a treat we are all different. Mrs O has only one kidney and I know she has had an awful time trying to find things that suit her I think her quest continues. There are lots to try just keeping asking for something that works for you, its trial and error. The very best of luck.
Hi,
Yes I have a good GP, but he admits quite freely that he he does not know much about renal cancer as it is quite rare. So self help groups are very useful!
KenR
Thanks Helen,
I will aim for the same route I think and hope it works out!
KenR
Keep us posted on how you are doing. Candesartan is a good one for getting bp down but I was on that and they advised weekly bloods on day 4 my potassium went up so good at the bp thing bad at the rest. I was on 200mg of moxonodine and 10mg of amlodipine, on dialysis could drop the amlodiphone but after transplant the anti rejection drugs play havoc for a bit then I was on none then they posioned me and I got norovirus lol so on steroids was back on both which helped off the steroids after 3 weeks dropped amlodiphine and will look to drop the other when I am sure its ok. My team are ok they leave most things to me as long as I tell them what I am doing. The only thing I never mess with is my anti rejection, but they are really good with me if I tell them its not right they check and amend not like the specialist hosp who poisoned me twice!. You will get there just keep going, may also be worth mentioning be aware should you need antibiotics as there are loads you cant have under 25% these are things I have picked up along the way so worth asking if need be ever