I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: chuckt67 on January 07, 2013, 02:54:19 AM
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I was just reading the most boring parts of my mom's med records (read the interesting stuff way to many times). Under allergies there are 2 items that by date match when my mom stroked out, unbeknownst to the staff, during a supposed carotid endarterectomy. I say supposed only because the surgeon told my mom at the end of their pre-op consult that my mom 'You are going to make me famous'. I've never become famous doing something I've done already. Since we were told the procedure went well, we waited close to an hour before alerting staff that our mom should probably be conscious by now. She was in critical care for about 4 days. The records show 2 allergies with notes:
Allergen: LISINOPRIL, Reaction: INCR CR DUE TO RAS, Date Noted: 10/31/2003
Allergen: HYPOTENSIVES, ACE INHIBITORS, Reaction: RENAL ARTERY STENOSI, Date Noted: 12/22/2003
First question, are these medications prescribed for stroke or is this a clue as to what this doctor was actually up to?
Second, I've found where a contraindication is stated that kidneys that are already starting to fail because of RAS will have the failure rate accelerate since the inhibitor blocks the only means the kidney can use to filter with in that situation, thus the INCR CR DUE TO RAS. But i haven't found anything confirming the second diagnosis of the HYPOTENSIVES, ACE INHIBITORS reaction causing RAS.
Anyone?
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I do know ace inhibitors are a no no if you have decreasing kidney function. I was on Benicar and no doctor stopped it until I was down to forty percent. Oops. I ended up in hosp for elevated bp where I was assigned a nephrologist that flipped out over my family dr still having me on an ace inhibitor. He told me that if your kidneys are sick and declining that ace inhibitors will finish them off.
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Lisinopril was what precipitated my final kidney failure. The ONE time I didn't do my research, I went ahead and switched because I wasn't happy with my then-current BP med. Of course, my primary doctor had no clue. My kidneys were already on their last leg but the lisinopril finished them off within a few weeks.
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I've been taking lisinopril for about 7 years, without any problems to date. My nephrologist was concerned about possible lisinopril reactions about a year ago, so he put me on amlodopine. Withing a month, I had severe edema in my legs, my blood pressure went up considerably, and I had blood in my urine. My bloodwork showed that my kidneys were heading downhill fast. The nephrologist put me back on lisinopril (but at a lower dose), and also put me on doxazosin in the evenings. The edema disappeared, my pressure went down, and my kidney output improved.
So, to make a long story short, SOME people are better off using ACE inhibitors even in late stage 4.
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I was on Lisinopril. My allergic reaction came one morning when I woke up with half of my tongue swollen! After many tries with different combinations of BP drugs, they finally put me on Amlodipine. I have had no issues whatsoever with that one.
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I find this all very interesting. I can't say I have much information, except that hubbys neph had him on lisinopril for some time. I know it can raise potassium, and that is why they had him stop taking it because they could not control his potassium. However I am interested in this causing decline in kidney function, since that is the med he was on leading up to the first transplant and later dialysis.... Surprised also that his neph would prescribe it given it appears to have such a known history of damaging kidneys.
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I had never looked into the exact reasons but I remember years ago being told not to take any ACE inhibitors or anti-inflammatories (ibuprofen, naproxen). I just can't remember if it was before or after my first transplant. I think before but that was a long time ago and my memory is shot.
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I know ibuprofen/naproxen are bad because they are filtered by the kidneys and can cause slow damage from prolonged use. I know I have not been allowed to take them after donating.
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Hmmm this is interesting. I was on Lisinopril for 3 years and was taken off of it due getting pregnant. I never had any problems when on it. I got back on it after the birth of my son, and even though I wasn't breast feeding because of being so sick with ESRD, I lactated for over a year. I never put two and two together until I mentioned it to my primary doctor. She did some tests and found that one of my medications was the issue. We narrowed it down to the Lisinopril and I stopped taking it. I've never heard of it damaging the kidneys more than helping with BP and function... strange!