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What Causes High BP After Kidney Transplantation?

Posted on Wed, 11 Jun 2014

Question: My friend has undergone with kidney transplant on 23 Feb 2014.
His conditions is stable but BP remains high after taking heavy dose of BP.
Why is it so ?

Answered by Dr. Ashish Verma (23 hours later)

Brief Answer:
it will take time to settel down

Detailed Answer:
Hi XXXXXXX

Thanks for writing to HealthcareMagic.

I read your query and understand your concern.

The thing is, apart from filtering impurities from the blood, our kidney produces various substances that help control the blood pressure also.

The earlier polycystic kidney being diseases was not able to mantain that, resulting in high bp. This new kidney will take some time to adapt to its new environment before its starts working to its full potential. The filteration works starts in a few weeks, but the other hormonal functions take a little longer.

Also bp is controlled by various other factors apart from the renal control like the heart, vessel walls, etc. So it will depend upon the other factors as well.

Hope i have been helpful.

Regards,
Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ashish Verma (1 hour later)

How can we control BP by other factors?
Can he go outside the home as 3 months have been passed ?

Answered by Dr. Ashish Verma (39 minutes later)

Brief Answer:
by medicines only

Detailed Answer:
Hi,

BP has to be controlled now with medicines only...there is no other alternative, till the transplaned kidney regains its all function.

But there is no guarantee of when and by how much it will come down, if any.

Regarding going out, if he is able to move out inside home normally then he can saftely go out. But try to make it gradual. Like first take him out in the park or any open and clean area near the house for some time for a few days. Then as he adapts you can increase slowly.

Regards
Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ashish Verma (24 hours later)

Thanks for you quick response Dr. XXXXXXX

I have one more question like as he has policystic kideny, few days back our treating Dr. told us to do some examination for Urine because they have some doubt for protein is going out from the urine.
Please see the below examination reports.

Urine Routine(Macroscopic)
Color : Pale Yellow
PH : 6.0
Specific Gravity : 1.020
Albumin : +
Sugar : Nil
Red blood Cells(RBC) : Full Field
Leukocytesv: 0-2
Epithelial Cells : 1-2

Urine Protein / Creatinine Ratio

Urine Protein : 33
Urine Creatinine : 89.47
Urine Protein /Creatinine Ratio : 0.37

Can you please tell me what is it mean ?

Answered by Dr. Ashish Verma (2 hours later)

Brief Answer:
he is loosing protein in urine

Detailed Answer:
Hi XXXXXXX

Normally there is very minimal protein excretion in the urine.

But here in your brother's case, his polycystic kidney is not able to hold back the protein in blood and as a result, a great part of it is being lost in the urine.

This is not good for the body as it will increase the workload of liver and he will start loosing weight and swelling in legs and dependent areas.

The routine urine test just detects the presence of protein in urine. It doesn't quantify it nor does it tells the type of proteins being lost. So you doctor want special tests to quantify and type the protein being lost, to help in its management.

Also, as per the urine report, a lot of blood is being lost as shown by the presences of RBCs. This will also need to be addressed as it will cause anaemia and weakness. Talk to your treating doctor about it.

Rest of the report is ok.

Regards
Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ashish Verma (13 hours later)

Thanks for your Response Dr. XXXXXXX

Treating Doctor also told us the same thing that Protein is going out in the Urine but it is going out from the polycystic Kidney and the transplanted kidney is functioning properly. so they can't do anything in this case or they can't do anything in the polycystic Kidney.

Can you please tell us what steps need to be taken ?

Answered by Dr. Ashish Verma (3 hours later)

Brief Answer:
the diseased kidney can be removed

Detailed Answer:
Hi XXXXXXX

There are two options -

1- You can increase his protein intake to compensate for the loss, as the loss in his case is not much (only single '+' in the report, but still it needs proper quantification).

2- if the above measure fails, and the transplanted kidney is working properly, then the diseased kidney can be removed. But the diseased kidney is not removed so early, as it acts as a backup, in case there is a graft rejection, which can occur anytime, but usually occurs within first 6-8 months.

So, i guess only the first option is feasible at the moment. Give it a try.

Regards
Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ashish Verma (1 hour later)

Thanks you so much for your Help & Guidance Dr. XXXXXXX

Answered by Dr. Ashish Verma (1 hour later)

Brief Answer:
.

Detailed Answer:
Hi XXXXXXX

I am glad that i have been of help to you.

If there are no further queries, you may close this discussion and rate the response.

Regards
Dr. Ashish Verma

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj