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I Have Been Diagnosed With Stage 3 Kidney Disease, The

Posted on Wed, 5 Jun 2019

Question: I have been diagnosed with stage 3 kidney disease, The only work up was labs and the fact that my blood pressure is 220/110 slight swelling in my legs. My BUN 23, CREATINE 1.23 ,Triglycerides 241, WBC 12.40, MCHC 31.7, RDW 16.0 , MPV10.10, NEUT 7.3, LYMP 3.9, MONO 1.0 I have had elevated B/P for years. Just not this high, I am on 2 B/P medications per day, Metoprolol 25mg 1 qd in AM and Losartin 50 mg at bedtime. Other meds I take is. Prilosec 40 mg q am, Lasix 40 mg qam, Jardiance 10 mg qam, BuspironeHCL 10 mg qam, Imdur Er 30 mg qam Ranexa 500mg qam, Asprin 81 mg qam, IQ+ Antioxidant 1 q am, Glucosamine & Chondroitin 1 qd, Fish oil 500 mg 1 qd, Ibuprofen 200m 1 or 2 prn. My symptoms, My face felt like a blowfish. Edema lower legs 2+, I feel off balance, light headed, I was taking Proxitine for anxiety & depression I took myself off this because it made me numb to feelings. have been off it for 2 1/2 months.

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

I have been diagnosed with stage 3 kidney disease, The only work up was labs and the fact that my blood pressure is 220/110 slight swelling in my legs. My BUN 23, CREATINE 1.23 ,Triglycerides 241, WBC 12.40, MCHC 31.7, RDW 16.0 , MPV10.10, NEUT 7.3, LYMP 3.9, MONO 1.0 I have had elevated B/P for years. Just not this high, I am on 2 B/P medications per day, Metoprolol 25mg 1 qd in AM and Losartin 50 mg at bedtime. Other meds I take is. Prilosec 40 mg q am, Lasix 40 mg qam, Jardiance 10 mg qam, BuspironeHCL 10 mg qam, Imdur Er 30 mg qam Ranexa 500mg qam, Asprin 81 mg qam, IQ+ Antioxidant 1 q am, Glucosamine & Chondroitin 1 qd, Fish oil 500 mg 1 qd, Ibuprofen 200m 1 or 2 prn. My symptoms, My face felt like a blowfish. Edema lower legs 2+, I feel off balance, light headed, I was taking Proxitine for anxiety & depression I took myself off this because it made me numb to feelings. have been off it for 2 1/2 months.

Follow up: Dr. Bhagyesh V. Patel (5 minutes later)

Please answer asap. YYYY@YYYY

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Please answer asap. YYYY@YYYY

Answered by Dr. Bhagyesh V. Patel (29 minutes later)

Brief Answer:
HTN affecting RAS, hydration, electrolyte /analgesic induced renal changes.

Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query and here is my advise.

* As per my clinical experience, Chronic kidney disease may be from various conditions
as long standing hypertension affecting renin angiotensin system, hydration
disturbances, electrolyte issues, analgesic as ibuprofen, blood thinner as aspirin or
else.

* Multiple parameters need to be corelated for evaluation of any condition, which needs
more relevant information as below, the acquisition of which would make the things
more better to answer the query more precisely.

1. If these data are considered recent one, any previous data available for comparison ?
2. Urination - amount, frequency details.
3. Any recent change in drug dosages if any ?
As BP is 220/110 , there must be predicted alterations in medications.

Awaiting for your response.
Regards.

Dr Bhagyesh ( MS consultant surgeon )

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (59 minutes later)

Dr Bhagyesh,
My blood pressure is not this high all the time. It is usually in the normal range 100/60 to 120 /70 I took it when I had symptoms of being blown up. I am on Lasix and Jardiance which both have diauretics, If I don't take them I can gain 10 to 12 lbs in 3-4 days. I have never had problems with my kidneys. No freq, or pain. I just don't feel right. I did take myself off of meds I felt was too much such as too much med for Cholestrol, Paroxtine, I do have an appt with a endocrinologist and a neph Dr. but not till July. I have waited over 1 1/2 months for appt and no one has called me.until a Nurse called to check on me. I told her I was still waiting for an appt. She said she had called the kidney Dr and they had my records, I called them and they said they didn't know anything about me. If I do have kidney disease don't I need to be seen right away, I am afraid I could die before I get seen. Am I being overly concerned about this.

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (15 minutes later)

Brief Answer:
follow up .

Detailed Answer:
Hi
Thanks for the details.

* As per the data, your BUN/Creatinine ratio is 17 which falls between the range for
demarcation of pre renal and renal azotemia.

* The associated corelation with urinary sodium, osmolarity and other parameters are of
vital importance to consider the detailed diagnosis and further management of the
symptoms.

* I do agree that early consultation with nephrologist will make condition much better
and faster, but be sure this is not life threatening at this stage as such from clinical
perspectives.

* My guidelines at present

- Maintain hydration for precise urine output.
- Keep blood pressure control vigilantly as that may hamper the issue.
- Regular walking, exercises.
- Restricted salt and protein intake in the diet.
- Avoid smoking or alcohol if consuming.

Do feel free to discuss further regarding the same.
Thank you.
Have a great day.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (47 minutes later)

Dr. Bhagyesh, I already feel better just talking to you. I know how hard it must be to help someone on the phone, I once had a Dr. named Jayish XXXXXXX I loved his passion for his patients care and he was very smart. I know I need to exercise, I became a recluse after losing my son from a prescribed Fentynal patch. for 10 years I sit on my rear end not wanting to do anything. That is why I was on the anxiety meds. I don't have any bad habits such as alcohol or smoking. I do care about my health especially now that I am older, I have good Genes in my family for long life. I am taking your kind advice and will exercise and cut down on salt and protein intake. You have lowered my stress level with things I can do for myself until I can see the Dr. May I please keep in touch with you regarding my issues? Like I said I have full confidence in your evaluation of me. Thank you, XXXXXXX

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (2 hours later)

Brief Answer:
follow up .

Detailed Answer:
Hi XXXXXXX
Welcome for the follow up.

* No appreciation for my medical support please, it is part of my moral responsibility.
Sorry to hear about your son, but after all that is part of everybody`s life.

* Be more concentrated over the aforesaid matters with meditations and YOGA which
will help immense through multiple modes of actions at almost all systems of the body.

* Again, be assured of nothing much serious or life threatening before consulting
urologist.

* Be Positive approach will keep your BP and health in excellent states.

You can always have follow up with me or even option of direct consultation is also available on website if you want in future.
Have a great day.

Regards.
Dr Bhagyesh

Above answer was peer-reviewed by : Dr. Nagamani Ng