Huge drop in blood pressure

[Laura]

Yesterday, my blood pressure dropped from it's usual 120/65 (I am on Toprol and Lotensin and they usually keep it pretty steady) to 85/42.  I slept most of the day and could hardly get up and walk around without feeling like I was going to faint.  I called my nephrologist's office & spoke to the dr. on call, who said there is no particular level that is considered "too low".  She said if I was symptomatic I should go to the ER.  But by then, I had eaten something salty to try and bring it back up and that was working.

Anyone else ever experience that?  If so, what did your doc tell you to do about it?  I'm not a doctor, but how low does it have to get before you are at risk of dying?  I'm not one to run to the ER, so I tend to not react some of the time when maybe I should. 

[Joe Paul]

I don't mention my complaints often, but I understand what you feel. Cant answer your questions as I have never asked myself. Good luck to you, hope they figure things out for you...Its hard at times Peace out.

[goofynina]

Hi Laura,  I am on PD and i have had my blood pressure drop that low once before (while at home that is)  when i was on hemo and that would happen they would give me broth, so i make sure i always have broth on hand and i helped that one time that i took it,  i wish i had more info to give you but that is pretty much it for me for now.   

[jasperkat]

My husband had that problem a couple of time after Hemo.  After I had to have the neighbors help me get him off the garage floor I insisted they do something.  As it turned out they were able to  take him off a couple of blood pressure meds and shift morning ones till evening.  I can remember how long you have been on dialysis but it seemed hubby's blood pressures improved substantially after  some time on dialysis.  Hope this helps and you are feeling better.

[Bajanne]

I have been having that problem too, but mainly when I am on the machine.  I have been down to the 70s/40s.  Then, they take care of it by putting saline in my line and putting my head lower.
It has happened at home (scary) and when I asked them what I should do, they said I should just lie down and rest.

[jbeany]

I've been on dialysis for just over a month.  I've been taken off two different bp meds since I started.  My doc told me to expect my bp to lower during the first few months, and to let him know if my pressure dropped to the point that it was bothering me.  He took me off one med the first week, and another during the second when I got so light headed at home that I nearly passed out in the shower.  I've been monitoring my bp with my own meter at home, and it hasn't dropped that much since.  Your doc should be able to adjust your meds.  If he doesn't, insist on it!  You shouldn't have to sleep your days away.  The actual numbers aren't as important as your quality of life.  Sometimes you just have to stomp your feet and demand some action.  (If you can stay awake that long!   )

[Rerun]

If you dialyze in the morning than wait until after dialysis and see what your BP is.  If it is low........do not take any medication.  If it is higher than normal than take them.  Monitor yourself like jbeany said.  I wear a wrist cuff at dialysis so I can see what my BP is when I start feeling hot and clammy.  Some people get ringing in their ears. 

I'm no doctor, but I'd rather my BP run a little high then that LOW bottomed out feeling.  And keep on your toes because it will not be the same from one week/month to the next.  I'm always shifting mine around to suite myself.

Best of Luck to you.

[Laura]

Hi Laura,  I am on PD and i have had my blood pressure drop that low once before (while at home that is)  when i was on hemo and that would happen they would give me broth, so i make sure i always have broth on hand and i helped that one time that i took it,  i wish i had more info to give you but that is pretty much it for me for now.   

Thank you.  That is helpful.  Maybe it was the salt in the broth that helped raise your blood pressure?  I'll try that next time.

[Laura]

Thanks, everyone!  I will let my doctor know because this is unusual for me.  I'm starting dialysis next month, but up until the past few months, my bp had been stable for several years.  I have been on the same meds since 2000 or so, so this is weird. But probably just another indication that I need dialysis now. 

[boxman55]

I take topal ,benacar, minoxidil and clonidine and some days I get to dialysis and my BP is over 200 then halfway through a run it will be 130, and then once in a while it will get to 80 or so, it feels very weird and scary when that happens.I have been playing around a little with my doses and checking my BP at home to try and get it right. I can't do any worse then the Doctor.--Boxman55

[Panda_9]

OMG dont listen to that Dr, he is a moron! For him to say "there is no particular level that is considered "too low"." is rediculous and wrong. If your BP is 85/42 and you are on BP medications, then it is probably a good indicator that some or all of the meds need to be stopped or reduced. If you are on hemo and have constant low BP, your fistula can clot off. Ideally you want your BP around 130-140 systolic pre and post hemo. If you are on PD, you probably need to be doing to weakest bags. It is definitely a good idea to monitor your own BP at home. I have been doing it for the past 6 years. Take it a couple of times a day around the same time and make a record of it. If it continues to be as low as you said, you need to see your doctor to have your medications reveiwed. I am not a doctor (am a nurse on dx), but personally I would stop at least one of the meds myself, but keep an eye on the BP, and get to the doctor as soon as possible. If you dont want to stop the meds on your own terms, get some salt into you. Hopefully you can get something sorted out quickly.

[BigSky]

I had some problems with bp once I became a Renalist.      Zack

Do not know if it was true but the doctor told me that when kidneys are failing that they can put out too much or not enough stuff to control bp and that they can constantly change between the putting out enough and too much.

[Laura]

I tried not taking my benazapril (Lotensin) for a few days and my bp stablized.  The doctor I spoke to was not my nephrologist, but someone on call in the nephrology dept.  My nephrologist is wonderful and I'm sure will change my meds when I let him know what happened.  He gave me his home and cell ph#, but I lost them (stupid - I know).  So I'll get it from him next appt. 

[RichardMEL]

Wow yesterday I had a shocking BP situation while on the machine. It dropped to 97/53 or so and no matter what they did it would not come back up. They lowered the temp in the unit, I lay all the way down, I had a hot drink.... nothing seemed to help and when I got off, it finally got up to around 105/60 or so.. I was OK until i got home and felt very faint etc... I then slept ALL NIGHT much more than usual, but still felt blah in the morning (I feel OK now though - late afternoon).

Luckily my sister gave me a home BP monitor, so i think I shall open it up and check myself out tonight!

I decided to not take my BP med today as I really didn't think I needed it.

[AlasdairUK]

I decided to not take my BP med today as I really didn't think I needed it.

If at all possible I would not take any meds for BP when on dialysis. Use your dry weight to keep your BP in check. If you are new to dialysis it might take a while, but I would start to reduce the BP meds as quick as possible.

[RichardMEL]

well, my doc lowered my BP medication a month or so ago and in general it seems to be ok.
Of course I only take it (or rather, am supposed to take it) on non dialysis days.

Today's session was much better BP wise... lowest it got was 108/65 odd and was all
good.

[Panda_9]

I decided to not take my BP med today as I really didn't think I needed it.

If at all possible I would not take any meds for BP when on dialysis. Use your dry weight to keep your BP in check. If you are new to dialysis it might take a while, but I would start to reduce the BP meds as quick as possible.

Alot of people still need BP meds even if they are at their dry weight. When someone first starts on hemo it takes time to figure out what the dry weight is, and until then, you probably will need BP medication.

[renal30yrs]

That has been my consistent theme with HD.  No matter what I do my pressure drops rapidly to the 80's.  In the old days I even ran with the pressure in 60's. (not a good thing).  Before starting HD I was very much hypertensive.  I needed 6 diffrent pressure meds just to contain my pressure within 160/90 range.

[Zach]

That has been my consistent theme with HD.  No matter what I do my pressure drops rapidly to the 80's.

Do you use Mannitol during treatment to help raise your pressure?  How about ProAmatine just before dialysis?

[renal30yrs]

I never heard about those meds.  Sounds very interesting.  Thanks fo the info.

[karen547]

I have experienced low BP and each time it has been while I am at  dialysis, I do hemo. Each time I get EXTREMELY hot and I sometimes will have seizures or pass out, it is very scary. I cannot believe a doctor would say theres not really a dangerously low BP-  thats stupid, why can there be a too high BP snd not a too low BP??! I take Metoprolol for my BP and Keppra for the seizures but thank god I'm not epileptic.

[Bajanne]

I have been having lots of problems with low BPs.  I have totally stopped my BP medication and it still tends to low.  However, they have upped my dry weight and I have less of a BP problem in terms of feeling really crappy.  It goes a bit low, but I feel okay, which is okay with me!
What I find, though, that they always seem at a loss what to do if I am not on the machine.  ER for example is no help to me if I am having a scary episode at home.  They never seem to know what I should do.   And if I have just come off the machine, and my lines are off, then again, the only thing they do is tell me to le quietly and test it over and over until they think they can let me go home.

[KT0930]

Years ago when I was on BP meds (lisinopril, I believe), it would occasionally drop very low, and after calling my neph the first three or four times it happened, he told me that if it was low (to use my own judgement, based on how I felt), to lower my dose that day. He also told me me that if it was starting to run lower consistently, that I could alter my own meds, within a range that he gave me. I think he told me that anything with a systolic above 100 and diastolic above 65 or so was acceptable, but like I said, that was years ago (and I wasn't on dialysis then).