Dr. Sandeep Varma
Nephrology
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Patient's Query
Hi doctor,
A few months ago, my elder brother was diagnosed with renal insufficiency, and his creatinine level was 7 at that time. After receiving treatment from the hospital, his creatinine level has reduced to 2.1 in the past few months. However, the major concern is that he continues to experience very high blood pressure, for example, 210/114 today, despite taking Arkamin 200 and Cilacar. We are considering if other drugs, like those from the Azilsartan group, may be suitable for him, as suggested by our nephrologist. But we want to stabilize his blood pressure; otherwise, in the coming days, it will affect his heart and may lead to LVH. Please guide me.
Hi,
Welcome to icliniq, and thank you for choosing us as your provider for health care.
I have gone through all your details and appreciate your concern.
From what I understand, your brother experienced an acute worsening of renal function following an episode of accelerated hypertension. It is likely that he had underlying chronic kidney disease. In such cases, blood pressure medications from the category of Azilsartan are effective for both lowering blood pressure and protecting the kidneys in the long run. However, while on such medications, it is important to closely monitor serum creatinine and serum potassium levels. If there is a trend of these levels increasing, it may be necessary to discontinue the medications or reduce the dosage.
I hope you are satisfied with my answer. For further queries, you can consult me at icliniq.
Thank you.
Patient's Query
Hi doctor,
Thank you again for your time; I greatly appreciate it.
Doctors told us that for patients with renal insufficiency, Azilsartan is likely to increase creatinine. That is why they prescribed Cilacar (Cilnidipine) and Arkamin (Clonidine), which have failed to maintain the blood pressure. My brother also has a very high lipid profile. Can you suggest any kidney-related blood pressure medicines to lower his blood pressure?
Hi,
Welcome back to icliniq.com.
Most of the time, this kind of accelerated hypertension is usually due to kidney disease. In such cases, Azilsartan-type medicine, which primarily acts on the kidneys, is very effective. Most of the time, we have seen an improvement in renal status when blood pressure improves and the pressure on the kidneys decreases with such medicines. It is also used for the treatment of heart failure, so it is good in that respect too. I would still suggest you start that. If he does not tolerate it, then there are certainly other classes of medicine for blood pressure that can be tried. Natrilix (Indapamide) tablets are also an option if his serum potassium is normal.
You can always come back and reach me at icliniq.com.
Thank you for consulting me.
Patient's Query
Hi doctor,
Thank you again for your time; I greatly appreciate it.
Are you online?
Hi,
You are very welcome.
Presently, yes. If you ever have more questions or need assistance in the future, do not hesitate to reach out. Take care.
Patient's Query
Hi doctor,
Thank you for your prompt reply.
I have been experiencing a slight stabbing pain in my chest for a while now, so I immediately did an ECG. Please take a look at the report and suggest what I should do. I also have some gastric formation in my stomach. I have attached the ECG graph. Please review the attachment.
Hi,
Welcome back to icliniq.com.
It seems that the ECG (electrocardiogram) is a bit abnormal. It would have been better if we had a previous recording to compare. ECG results should always be interpreted in conjunction with the accompanying clinical history. I suggest you visit a doctor as early as possible to rule out any significant issues.
I hope this has helped you.
Thank you.
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Nephrology
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