I have never had elevated blood pressure and am fit and active. i have been dx in past year with mildly impaired kidney function but do not have any of the risk factors that usually contribute to this i.e. cause unknown. My gp was not offering any treatment plan but when i asked questions about impaired kidney function and causes she prescribed 2mg perindopril. As it seem perindopril is mainly to reduce blood pressure, is for life and may have other effects I'm not sure whether to take this or not. Anyone else in this situation or can add a bit more light ??
Perindopril is a part of group of medicines called ACE inhibitors. Some of these have been shown in trials to help slow down a decline in kidney function in patients with and without high blood pressure or diabetes. Have you had any urine specific tests done ? I would try to make sure the GP is clear as to what reason she has for prescribing this.
Tarun (hospital pharmacist)
Thank you for that. Yes I have had a couple of urine and blood tests and just recently a 24hr urine test. I think her thoughts were it would help to protect my kidneys but as she suggested it almost as an afterthought i wasn't sure and she didn't go through any of the things i should avoid if I was on them. I did ask the pharmacist when I picked up the script and she gave me a bit more info about that e.g. potassium. As i've never taken any meds beyond a few panadol I'm wary of taking them unless i know that this is something that will help to make a difference e.g. keep my kidneys functioning better/longer. It sounds though from your response they have found that this does help.
I think that explains it - in a person with normal kidney function, their kidneys would be doing a good job of filtering blood to remove all the rubbish which is excreted in urine. Blood contains a lot of proteins which are large molecules and therefore are very unlikely to get filtered out into urine. However in patients with kidney damage proteins are more likely to pass into urine as the kidney''s filtering mechanisms work less well. Hence urine tests can often pick up elevated amounts of protein which probably prompted your GP to prescribe the perindopril. In terms of things to be aware of, you should be having kidney function tests after starting the drug. If you're not sure as to whether this is being arranged pester your GP as it's important to keep an eye on the kidneys and the effect of the medication. It can raise potassium levels in your blood but this is only really important if you're taking other meds which have the same side effect. Otherwise it is pretty quickly picked up on blood tests.
Thank you again. Your responses are much appreciated and the information has been helpful. I do have another blood test booked in for about 3 months time. I was wondering if you have any more info on the trials re the ACE inhibitors? I was wondering how effective they were at slowing down decline in kidney function? Are they talking weeks? months? or years? I'm asking because I notice a reluctance on my part to take any meds unless I am really sure they are worth taking. The idea of taking meds for the rest of my life is so foreign to me it is taking a bit of mental adjustment to consider it.
Hi
Unfortunatley I cannot fully access the primary literature but monthly monitoring was done in trials of ACE inhibitors with benefits consistently seen over a couple of years of treatment. In practice however I'm not sure whether monthly monitoring is convenient or ideal. You might want to look at the information leaflet below from this site. As I've said it appears that this is the reason why your GP prescribed the perindopril but I cannot say for sure unless you hear it from their mouth !
https://patient.info/health/proteinuria
Hi, Yes I have a better idea now of all the questions I need to ask at the next appt. Unfortunately most GP's seem to be time pressured and don't really want to engage in conversation that could chew up more time. Her response was to prescribe the perindopril as soon as I began to ask questions but I needed more information to both understand the dx and the reason for these meds so I can make informed decisions. This is a great service and I really appreciate the time you have taken to respond. Thank You