What causes high blood pressures the day after dialysis?

[jo]

My mom's blood pressures have been very high since the past week (systolic over 190). This is often seen the very next day after dialysis. The pulse rate averages about 68. Her hemoglobin is 7.8 currently and she is being treated with Aranesp and iron for anemia. The doctors couldn't figure out the cause of her high blood pressures. We even went to hypertension specialist who thinks it could be stress related, but I am not sure if I will agree with that as this happens even when she is stress-free. Anyone had similar experiences? Please help.

[kickingandscreaming]

even when she is stress-free

No such thing.  Most people don't recognize when they're under stress, much of the time.  We are always under some kind of stress.  So I doubt that your mom was stress-free.  BP is very subject to emotional states (that we're not in control of) and it's easy to get in patterns (e.g. right after dialysis, etc.).





sp mod Cas

[Fabkiwi06]

Assuming you're ruled out some kind of massive fluid intake, it probably is somewhat stress related. Mine tends to be anxiety related. Maybe mom can try meditating or deep breathing exercises when she sees the spike. See if they help your blood pressure go down after 20 minutes or so of some kind of relaxation technique.

[jo]

I forgot to mention that she gets about 250 mg of Cefazolin after every dialysis treatment to treat her blood infection. She was put on the antibiotic for a total of 1.5 months. As you guys say, it could be related to stress or anxiety. But I know if she is stressed or not and she tells us if she feels stressed. In this specific case, I am wondering if it is something else that elevates the blood pressures. Is low hemoglobin related to high blood pressures?

[Fabkiwi06]

Sometimes you can be physically stressed and not emotionally stressed. Recovering from a blood infection would lead me to think that part of the reason her BP is going high is due to her body going in to that natural fight or flight mode that it tends to do during an infection of sorts.

If all other causes have been ruled out by the doctors - too much fluid... pain... higher sodium intake... etc - then I'd keep an eye on it to see if it changes once Mom is off the antibiotic. Maybe talk to the doctors about BP med adjustments in the meantime.

[KatieV]

I forgot to mention that she gets about 250 mg of Cefazolin after every dialysis treatment to treat her blood infection. She was put on the antibiotic for a total of 1.5 months. As you guys say, it could be related to stress or anxiety. But I know if she is stressed or not and she tells us if she feels stressed. In this specific case, I am wondering if it is something else that elevates the blood pressures. Is low hemoglobin related to high blood pressures?

I was just on Cefazolin for a tunnel infection.  I self-administrated it after each dialysis treatment directly into my catheter over the course of 15 minutes.  I already had super high blood pressure, so didn't notice a difference.  However - it caused my heart to race and feel like it was doing somersaults!  My heart physically hurt.

Cefazolin also did a number on my gut; I had severe diarrhea (not C-diff).  A bunch of yogurt and kefir from my family's Jersey cow, Fern, helped resolve that problem! 

[kitkatz]

Dialysis itself creates stress on the body, plus blood infection makes it even harder for her body to be recovering each day after dialysis.

[jo]

Sometimes you can be physically stressed and not emotionally stressed. Recovering from a blood infection would lead me to think that part of the reason her BP is going high is due to her body going in to that natural fight or flight mode that it tends to do during an infection of sorts.

If all other causes have been ruled out by the doctors - too much fluid... pain... higher sodium intake... etc - then I'd keep an eye on it to see if it changes once Mom is off the antibiotic. Maybe talk to the doctors about BP med adjustments in the meantime.

The docs still keep saying it is due to her fluids. We went for dialysis two days in a row and the BP is still high (over 190), and she was at her dry weight on both the days. At-least now, they wouldn't say it is the fluid gain. I guess we will need to watch out for her symptoms once she is off the antibiotic like you said. Thank you.

[jo]

I forgot to mention that she gets about 250 mg of Cefazolin after every dialysis treatment to treat her blood infection. She was put on the antibiotic for a total of 1.5 months. As you guys say, it could be related to stress or anxiety. But I know if she is stressed or not and she tells us if she feels stressed. In this specific case, I am wondering if it is something else that elevates the blood pressures. Is low hemoglobin related to high blood pressures?

I was just on Cefazolin for a tunnel infection.  I self-administrated it after each dialysis treatment directly into my catheter over the course of 15 minutes.  I already had super high blood pressure, so didn't notice a difference.  However - it caused my heart to race and feel like it was doing somersaults!  My heart physically hurt.

Cefazolin also did a number on my gut; I had severe diarrhea (not C-diff).  A bunch of yogurt and kefir from my family's Jersey cow, Fern, helped resolve that problem!

Thanks for sharing this. I hope you are feeling better now. I am assuming may be it is the antibiotic that is causing something to my mom.

[jo]

My mom has completed her course of antibiotics for the blood infection last week. I was thinking that her elevated BP's could be because of the antibiotics. Now she has been off the antibiotics and her systolic BP is still about 200 and her BP medications doesn't seem to help. At dialysis, they keep saying that the elevated BP's are because of her fluids and they have to pull more. But, my mom doesn't have fluids and she is already close to her dry weight and they cannot pull more fluids past her dry weight even with extra treatments. Has anyone been in this situation before? I am crying here without knowing the cause of the elevated BP readings. Please help.

[cassandra]

As I wrote in the other thread where you ask this, I read that some antibiotics can cause raised BP, or reduce the working of BP meds. But CKD itself can cause it too. How do you know your mum is at her dry weight?

Love, Cas

[jo]

As I wrote in the other thread where you ask this, I read that some antibiotics can cause raised BP, or reduce the working of BP meds. But CKD itself can cause it too. How do you know your mum is at her dry weight?

Love, Cas

Yes Cas. I read your post in the other thread. She is at her dry weight as they cannot pull any more fluids beyond the dry weight and my mom feels better at that weight.

[Charlie B53]

Scientists are hard at studying the beneficial effects of many of the natural bacteria within the digestive tract, and how many of these can cause things to occur to the body.

Antibiotics are not very selective in killing off bacteria.  Indiscriminately killing both the bad bacteria as well as much of the good.

I too have long been taking antibiotics for a twice occuring peritoneal infection.  Dosing my bags every night and have seen almost 25 point rise in my blood pressures for the last 2 1/2 months.  Dr ordered another BP med yesterday.  I will receive it in the mail in a couple of days.

I expect that over the next two weeks as the lingering effects of the antibiotics wear off my pressures to stabilize.  The new med may bring them down a little, but more so, I expect over the next three months for the beneficial bacteria in the gut to regrow that my pressures to begin to fall low enough that I will have to stop taking this new BP med.

Re-establishing the'normal' colonies in the gut is critical to maintaining health.  Eat those foods that boost these and give it a little time.

[jo]

Scientists are hard at studying the beneficial effects of many of the natural bacteria within the digestive tract, and how many of these can cause things to occur to the body.

Antibiotics are not very selective in killing off bacteria.  Indiscriminately killing both the bad bacteria as well as much of the good.

I too have long been taking antibiotics for a twice occuring peritoneal infection.  Dosing my bags every night and have seen almost 25 point rise in my blood pressures for the last 2 1/2 months.  Dr ordered another BP med yesterday.  I will receive it in the mail in a couple of days.

I expect that over the next two weeks as the lingering effects of the antibiotics wear off my pressures to stabilize.  The new med may bring them down a little, but more so, I expect over the next three months for the beneficial bacteria in the gut to regrow that my pressures to begin to fall low enough that I will have to stop taking this new BP med.

Re-establishing the'normal' colonies in the gut is critical to maintaining health.  Eat those foods that boost these and give it a little time.

I hope you get better soon. Thanks for the info.

[Fabkiwi06]

I added a OTC probiotic a few months ago to my daily mess and it's helped a lot with general overall feeling better. Pre-dialysis, when I occasionally needed antibiotics, I'd eat a yogurt a day during the course. Helped lessen some of the *ahem* side effects.

Check and see if that works with your current situation. I use the generic acidophilus I find for $6 at Kroger.

[jo]

I added a OTC probiotic a few months ago to my daily mess and it's helped a lot with general overall feeling better. Pre-dialysis, when I occasionally needed antibiotics, I'd eat a yogurt a day during the course. Helped lessen some of the *ahem* side effects.

Check and see if that works with your current situation. I use the generic acidophilus I find for $6 at Kroger.

Ok thanks.

[Charlie B53]

How do you KNOW what Mom's 'Dry Weight' is?  Have they drawn off enough water during treatment to cause dizzyness or blood pressure drops?    Until Mom's has a negative reaction there is no 'perfect' method of determining 'Dry Weight'.

I had always thought I was very well 'fluid balanced' while doing PD at home for 3 1/2 years.  This re-occuring infection causing me to lose my PD Cath and go on Hemo for a while has really opened my eyes.  So far we have taken off FIFTEEN POUNDS below what I had always thought was my balance weight.

I did have two nights of leg cramps after treatments, so we decided to increase my weight a half kilo.  No more night cramps.  So I am pretty sure we have found what should be very close to a real 'Dry Weight' for me.

A long talk with Mom's Dr and Tech may be helpful in deciding just how much water to pull off.  Increasing or rather decreasing her weight just .1 per treatment until Mom begins to have any signs or symptoms should be a safe course.

[jo]

How do you KNOW what Mom's 'Dry Weight' is?  Have they drawn off enough water during treatment to cause dizzyness or blood pressure drops?    Until Mom's has a negative reaction there is no 'perfect' method of determining 'Dry Weight'.

I had always thought I was very well 'fluid balanced' while doing PD at home for 3 1/2 years.  This re-occuring infection causing me to lose my PD Cath and go on Hemo for a while has really opened my eyes.  So far we have taken off FIFTEEN POUNDS below what I had always thought was my balance weight.

I did have two nights of leg cramps after treatments, so we decided to increase my weight a half kilo.  No more night cramps.  So I am pretty sure we have found what should be very close to a real 'Dry Weight' for me.

A long talk with Mom's Dr and Tech may be helpful in deciding just how much water to pull off.  Increasing or rather decreasing her weight just .1 per treatment until Mom begins to have any signs or symptoms should be a safe course.

Yes, she had blood pressure drops, nausea, dizziness and other symptoms when they try to push more than what she could tolerate. That is how we determined that should be her dry weight. But the dialysis nurse practitioner doesn't agree and keeps saying that it is the fluid that is causing the blood pressure spike everyday. I don't agree with that at all.

[beep]

I'm begining to wonder whether its the B.P. medication I take that's causing my pressure to rise and stay high
its funny u know u go to ur GP n she takes my B.P. 165/65   n its like WOW U'VE got HIGH B.P.  yet you go to dialysis clinic n ii's like 195/75  and they say thats ok
why in 1 place it's high n in the ohter place its ok??
i can't work these people out







sp mod Cas

[Charlie B53]

My pd Team tells me they would be happy if my pressure stabilizes around the 150's.  Dialysis is a strain on the body and attempting to medicate to get more 'normal' pressures can lead to too many pressure drops, causing fainting.  They do not want to cause low pressures.

Since we all are slightly different BP meds do not all work the same on all of us.  There are a number of meds that her Dr will try and wait to see how well each medication will work on her.   This isn't going to happen over night, but it is important that Dr stays aware and keep adjusting the dose andor the type of medication until Mom's pressures stabilize in a more acceptable range.

It is difficult to be patient.

[Hazmat35]

My mom's blood pressures have been very high since the past week (systolic over 190). This is often seen the very next day after dialysis. The pulse rate averages about 68. Her hemoglobin is 7.8 currently and she is being treated with Aranesp and iron for anemia. The doctors couldn't figure out the cause of her high blood pressures. We even went to hypertension specialist who thinks it could be stress related, but I am not sure if I will agree with that as this happens even when she is stress-free. Anyone had similar experiences? Please help.

My BP when I get to Dialysis is OFF THE CHARTS....close to 200 if not higher....!  Mine is stress related.  I am highly needle-phobic and I am rushing from work to get there in time! 

Now, they tell me not to take my BP meds in the morning of Dialysis, just skip that dose; and continue back that evening and the next day...then skip Dialysis day....etc...etc...!  so far it has worked great; and no trouble with keeping the BP under control.  But...that is me...!  Doesn't work for everyone.

[Simon Dog]

why in 1 place it's high n in the ohter place its ok??
i can't work these people out

When I see the renal dietician, I am told to eat only white bread and avoid whole wheat.  When I see the cardiologist, he tells me to avoid white bread and eat only whole wheat.






sp mod Cas

[Charlie B53]

I have had to learn to control my carbs very tightly, otherwise my sugars climb.  White flour in AN form is a big No No for me.  We buy that 35 or 40 carb Whole Wheat bread.  It actually feels and tastes like real bread.  Not half bad.

And my phos and pot are both well within acceptable limits.  It ain't always easy, skipping all the things I would have otherwise eaten.

I skip half my BP Meds on Dialysis mornings, but soon as I return home I take them and my usual water pills to keep what little kidney function I have left, producing.  I think that little bit makes that big difference in my labs.

One thing I forgot to mention, long term antibiotic use can leave a person very susceptible to a fungal infection.  Those many months fighting that persistent PD infection Dr also had me taking an antifungal med.

ANY stress on a body can raise Blood pressure.  It can be a very difficult task to determine exactly what is causing the pressure rise.  Dr's don't bother looking for the cause, they just prescribe a med and attempt to treat the symptoms.  It is up to us, we have to really search, and hopefully find the root cause.  Then we can learn to make the small change that can help make a permanent reduction in the stress.

It ain't going to be easy.