Blood Pressure Issues

[GuyIncognito]

Good Day,

  Just wanted to run this by the crowd... I have been on Dialysis for 4 years now and all of a sudden I can't control my blood pressure, my Neph. has ramped up the pills and still I'm throwing out 140's / 90's... is anyone else going thru this kind of situation and it is something I should be worried about?




EDITED:  Moved thread to proper section - Goofynina/Moderator

[Michelle]

Have you got extra fluid on board. I know in the past that if this is the case pretty much nothing lowers the BP until the fluid balance is back to normal. You can hide fluid in your tissues etc, so think it isn't there but it is especially if you have lost wieght as you lose the flesh but it is replaced by fluid and yet the target weight doesn't alter that much. Otherwise maybe your meds need to be changed as they aren't as effective now but more likely there is a reason behind it.

[GuyIncognito]

I have recently had my pills changed so it could be a fluid issue but as my dry weight has dropped from 70 to 68.5 this summer and I'm feeling rotten afterwards I'm not so sure.

Dialysis Days
Norvasc 10mg.
Trandolapril 4mg.
Atenolol 25mg.

Non Dialysis days
Norvasc 10mg.

[Epoman]

Good Day,

  Just wanted to run this by the crowd... I have been on Dialysis for 4 years now and all of a sudden I can't control my blood pressure, my Neph. has ramped up the pills and still I'm throwing out 140's / 90's... is anyone else going thru this kind of situation and it is something I should be worried about?




EDITED:  Moved thread to proper section - Goofynina/Moderator

LOL you and your doc are concerned about 140/90  When my BP was out of control it was 250/150 try that on for size.  Now my pressure is to low 100/60 and I stopped my BP meds 6 months ago (a lot has to do with my thyroid levels, read my bio) So now I am worried that my heart is to weak to sustain higher pressures. Seriously 140/90 for a dialysis patient is not bad. But that is just my opinion and from whatI have heard from nephs.

[BigSky]

LOL you and your doc are concerned about 140/90  When my BP was out of control it was 250/150 try that on for size.  Now my pressure is to low 100/60 and I stopped my BP meds 6 months ago (a lot has to do with my thyroid levels, read my bio) So now I am worried that my heart is to weak to sustain higher pressures. Seriously 140/90 for a dialysis patient is not bad. But that is just my opinion and from whatI have heard from nephs.

Pretty much the same I heard from my doc.  Never seemed concerned when my pressure was in the 140/90 range.  Said it was ok for dialysis patients to run a little higher pressure over what most people run.

[angieskidney]

LOL you and your doc are concerned about 140/90  When my BP was out of control it was 250/150 try that on for size.  Now my pressure is to low 100/60 and I stopped my BP meds 6 months ago (a lot has to do with my thyroid levels, read my bio) So now I am worried that my heart is to weak to sustain higher pressures. Seriously 140/90 for a dialysis patient is not bad. But that is just my opinion and from what I have heard from nephs.

Pretty much the same I heard from my doc.  Never seemed concerned when my pressure was in the 140/90 range.  Said it was ok for dialysis patients to run a little higher pressure over what most people run.

I have been taking my own BP since I was 9 years old so I know a lot about this. You don't want it too low (lowest I have been is 85/35) and you don't want it to be too high (highest mine has been was 240+-/180) but that is a given. Go by how you feel. I find when my BP is too high I get a bad headache and when it is too low I get dizzy and have to get up real slow. 140/90 is high only for a healthy person but for a dialysis person it is expected that your BP will be that high. What BP is right for each person depends on each person. If your BP is usually a LOT lower than that .. then that is probably high for you.

My BP was high for the last 5 years on PD but now that I am on HD I had to get off of all 4 of my BP pills (2 were the same as yours). Your Neph might want to put you on the same dose every day instead of what he has you on. Just talk to your Heph about this. I know with mine however, I have felt like they are guessing. When my BP was so low and they were slowly taking me down my 4 different pills (3 of one, 2 of another, another on 3 pills multiple times a day, and the 4th was just one pill daily) til it got to the point where I just asked the dialysis unit if I could just come right off of them because I was tired of crawling everywhere (an exaggeration but I didn't appreciate being a 32 year old that had to sit for 1/2 hr at Walmart before I could go home because I was too dizzy).

I spent years with high BP but only your Neph can adjust your meds. But research on your own is helpful to see what each type of BP pill does and which would probably benefit you more so over others.

Here are some links to check out:

• http://mytarka.com/c_treating.html
• http://www.abouthypertension.info/treatment/medications.php

I hope this helps some .. good luck!

[BigSky]

I have recently had my pills changed so it could be a fluid issue but as my dry weight has dropped from 70 to 68.5 this summer and I'm feeling rotten afterwards I'm not so sure.

Dialysis Days
Norvasc 10mg.
Trandolapril 4mg.
Atenolol 25mg.

Non Dialysis days
Norvasc 10mg.

How is your blood pressure after dialysis?

Reason I ask is BP tends to rise between treatments because of fluid.  It would make more sense to take the bulk of medication on non dialysis days when pressure is rising and less on dialysis days as pressure usually drops in most patients after dialysis.  Also some medications are dialyzed out so that may or maynot be an issue.

[kitkatz]

My blood pressure goes into sky high range if I do not take the meds daily.  I take my meds even on dialysis days.  I work full time and I think the stress level is high at work so I need the meds to cool the pressure days I am working.  They told me do not take your meds on dialysis days.  Are they kidding? I would go in with super high pressure after work.  Nope, everyday whether I feel like it or not those meds are taken.

[Panda_9]

140/90 isnt bad as everyone else has said. You dont want it too low otherwise you wont be able to handle HD. Naturally it usually is a little high post HD due to all the blood and fluid being run back into you. I would be considering taking most of the BP meds on non dialysis days as BigSky also said. If you are taking all those meds on a dialysis day, it may mask the effects of extra fluid on board. Just a thought you could take up with your neph. Also you could try dropping your dry weight by 200ml each treatment, which may help to bring it down. Obviously we arent doctors, but this is all coming from our own experiences. Raise any issues with the neph, and by all means tell them what has been bought up here.

[angieskidney]

Ya, I discuss so much with the Neph I only see once a month and this past Monday he said to me, "You are going to put me out of a job" jokingly because I was suggesting things to him that he agreed with instead of him telling me lol

[Panda_9]

Thats great Angie 

[Ken Shelmerdine]

Ya, I discuss so much with the Neph I only see once a month and this past Monday he said to me, "You are going to put me out of a job" jokingly because I was suggesting things to him that he agreed with instead of him telling me lol

I think it's true to say  we become experts of our own health condition. When I was pre-dialysis my potassium level went to 6.9. This level was considered to be so bad that I got a call to go to A&E immediately. They took it again at the hospital and it had come down to 6.2. which is still high. Now a few weeks previously I'd asked my renal doc if I could reduce the strength of one of my BP meds  (Beta Blockers) and maybe compensate with a higher dose of the other tablet I was taking (Candesarten, an ARB blocker) He cut the beta blocker to half strength (2.5ml) and doubled the ARB to 16ml. The day I got the call to go to A&E I had earlier in the day seen an article on the net about a clinical study that indicated ...wait for it.... raised serum potassium blood lab readings in patients using ARBs. I mentioned this to the A&E medic and after disappearing for about 10 minutes I guess to get someone else's opinion or look it up in a book,(God knows) He came back and agreed that yes this could indeed be the cause..Doh, Who's the bloody Doctor??!!!!!!!! Came off the ARB completely, replaced it with a diuretic and in 2 weeks it was down to 4.8. 

[renal30yrs]

Good Day,

  Just wanted to run this by the crowd... I have been on Dialysis for 4 years now and all of a sudden I can't control my blood pressure, my Neph. has ramped up the pills and still I'm throwing out 140's / 90's... is anyone else going thru this kind of situation and it is something I should be worried about?

In the old days they performed nephractomy a lot.  The reasoning was the diseased kidney's overproduction of rennin.



EDITED:  Moved thread to proper section - Goofynina/Moderator

[Epoman]

Good Day,

  Just wanted to run this by the crowd... I have been on Dialysis for 4 years now and all of a sudden I can't control my blood pressure, my Neph. has ramped up the pills and still I'm throwing out 140's / 90's... is anyone else going thru this kind of situation and it is something I should be worried about?

In the old days they performed nephractomy a lot.  The reasoning was the diseased kidney's overproduction of rennin.



EDITED:  Moved thread to proper section - Goofynina/Moderator

renal30yrs, please see this thread about proper use of quoting. Thanks. http://ihatedialysis.com/forum/index.php?topic=2593.0

- Epoman
Owner/Admin

I left the quote tag error in my quote in place as an example.

[Andy55]

My BP has been uncontrollable for 15 years....I wish I could stabilize at 140/90.....even with a dozen different BP med cocktails it is rarely less than 150/100-110.....and similar to Epoman's comment about having an extra high BP event...it has reached stroke levels...when your BP is reaching for the stars it is interesting/sad when the nurse/intern takes the BP and misses it by a mile...they must not trust what they're hearing.......I just shake my head when they tell me their reading...one Neph said my body has just gotten used to high BP...anyone ever hear that from a doc?

[tubes]

one Neph said my body has just gotten used to high BP...anyone ever hear that from a doc?

Yea, I have Andy55.  Mine use to run way high like epomans....180's/120's sometimes even higher.  Now it runs about 150's/100's before dialysis and about 130-140/90-100's after dialysis.

I take norvasc 10 mg everyday.  I also have enalapril and one other that I don't take anymore.  I wish they would put me back on 'em.  I wanna get in under control. 

[Rerun]

Mine is high too.  That is what took my transplant.  Uncontrolled blood pressure.  I wanted to eat the whole jar of pills to see if that would even drop it......but I knew it probably would...drop me to the ground.

Mine is fine 140/80 after dialysis until I get out the door and then bam back up to 165/95 or higher.

[Sluff]

Mine runs real high and still borderline with meds. Sorry I don't remember exactly the numbers. I see the Neph on friday.

[angieskidney]

THey thought I had too much renin but it wasn't that. After awhile on HD my BP came down to normal. It was always very high on PD and I was on 4 BP pills. Then on HD they took me down to 2 but didn't want to take me off the other 2 so I gradually took myself off and then told them 2 months later that my BP is perfect and that I hadn't taken any BP pills. They weren't happy but I was tired of having a BP of 78/35 


Also on the note of BP, Sandman was asking how high BP can cause kidney failure in healthy people. Can anyone answer this for him? Thx! 

[renal30yrs]

My pressure was 190/100 with various medications to supposedly control hypertension (runs in the family) before going back to HD.  Nowadays averages around 100/60.

[livecam]

I never had a problem with BP before starting dialysis.  After starting it was generally on the high side so I was placed on a couple of meds to control it.  Early on it we found that my BP always increased during treatment.  This is because some dialysis patients overproduce renin which naturally increases blood pressure.  Damaged kidneys are prone to overproducing renin with the body seeing the actual dialysis treatment as a form of stress which stimulates the renin response.   I was switched from med to med but nothing really seemed to control the problem completely during treatment.  At 2 years plus on dialysis the problem was getting critical.  My BP was going very high within an hour or two of the start of my run.  Many times the unit nephs had to be paged for an ok to administer BP meds during treatment.  One time it went to something like 200/110 and it was ER time.  Fortunately the ER was located on the same campus as the dialysis unit so it was just a short walk over there.  I was starting to think that if something didn't change pretty quick I was going to stroke out someday on dialysis.  The change came along in the form of a transplant.  I've continued on BP meds since then but I lower them from time to time with excellent BP control.  I'm taking about half of what I'm supposed to be taking and all looks good in the 120/70 range plus or minus a little.