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Can low BP cause a sudden eGFR drop in my grandmother at 81?

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Patient's Query

Hello doctor,

I am seeking your guidance regarding my grandmother, who is 81 years old. She was diagnosed with kidney shrinkage and CKD stage 3 in April 2025. Since then, she has been on regular treatment, but over the past year, she has been hospitalized many times for different issues.

As a family, we are becoming increasingly worried and confused about whether this is part of the natural course of her illness or if something more should be done.

Since her diagnosis, her health journey has been as follows:

  1. April 2025, she was diagnosed with CKD Stage 3.
  2. August 2025, hospitalized for very high blood pressure.
  3. September 2025, she developed compression fractures of L1, L2, and L3, which were treated with medications and an LS belt.
  4. November 2025, again admitted because of uncontrolled high blood pressure.
  5. February 2026, hospitalized for high blood pressure along with shivering and tremors.
  6. April 2026, another admission for high blood pressure and body tremors.
  7. May 2026, Admitted due to poor appetite and low potassium levels.
  8. June 2026, hospitalized after a sudden spike in blood pressure with tremors.
  9. Currently, she is admitted once again.

Her current medications include Clinidipine 10 mg (SOS), Ecosprin 75 AV, Dytor 20 mg, Myklo K2, Uprise D3, Megace 40 mg, and Solikem.

What worries me the most is that during this admission, her blood pressure has become quite low, often around 88/47 mm/Hg or 96/56 mm/Hg. She does not have swelling in her legs at present.

Her latest kidney tests have also alarmed us. Her serum creatinine is 1.3 mg/dL, but her estimated glomerular filtration rate (eGFR), which had been around 33–40 mL/min/1.73 m² for almost a year (Stage 3 CKD), has suddenly fallen to around 17–20 mL/min/1.73 m² over the last few days, suggesting Stage 4 CKD. This sudden drop has made us very anxious.

I would really appreciate your opinion on a few things:

  1. Why is she requiring hospitalization so frequently?
  2. Is this something which is seen in elderly patients with CKD, or could there be an underlying issue that needs further evaluation?
  3. Could her current low blood pressure be causing a temporary worsening of her kidney function?
  4. Does her treatment plan appear reasonable, or should we consider getting a second opinion from another nephrologist?
  5. What can we do to help keep her stable, avoid repeated hospital admissions, and maintain the best possible quality of life for her?

We understand that age and CKD can bring challenges, but seeing her go through repeated admissions has been emotionally exhausting for our family.

We would be grateful for any guidance on whether we are on the right path and what more can be done for her long-term care.

Kindly assist.

Thank you.

Answered by Dr. Murugan Sivalingam

Education:

MBBS

Professional Bio:

Dr. Murugan Sivalingam is a highly experienced nephrologist and internal medicine specialist dedicated to delivering comprehensive kidney care and managing complex medical conditions. He combines advanced expertise with compassionate patient care, focusing on personalized treatment plans and improving overall health outcomes.      

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

I have carefully reviewed the details you provided about your grandmother's health.

I understand your concern, especially given the number of hospitalizations she has experienced over the past year.

Based on the information available, it is unlikely that her repeated admissions are due to chronic kidney disease (chronic kidney disease, which is the gradual loss of kidney function over three months or more) alone. Patients with creatinine values around 1.3 to 1.7 mg/dL typically do not develop the symptoms you have described solely because of kidney dysfunction. Therefore, it is important to look for other contributing factors as well.

Low blood pressure in an elderly patient is concerning. It could point to dehydration, an infection, reduced heart function, or another acute issue. Even a temporary drop can reduce blood flow to the kidneys and cause a significant fall in eGFR [estimated glomerular filtration rate — a measure of how well the kidneys are filtering].

If she was given pain medications for the spinal fractures — particularly anti-inflammatory painkillers — those could have contributed to both the kidney decline and the blood pressure fluctuations. Any such medications should be reviewed with her doctor.

With blood pressure running low right now, her antihypertensive medications may need to be adjusted temporarily. This is common blood pressure medicines are often paused or reduced and then reintroduced gradually once things stabilize.

To better understand the reason for the recent decline in kidney function, I would recommend the following investigations if they have not already been performed:

  1. Ultrasound of the abdomen and kidneys to assess kidney size and rule out any urinary obstruction.
  2. Urine routine examination to look for infection, protein loss, or other abnormalities.
  3. Blood calcium and electrolyte levels.
  4. Evaluation for infection and assessment of heart function if clinically indicated.

The recent drop in eGFR [estimated glomerular filtration rate] doesn't necessarily mean permanent kidney damage. Dehydration, infection, low blood pressure, or certain medications can all cause a temporary dip in kidney function one that often improves once the underlying cause is sorted out.

At this stage, I would focus on identifying the cause of her low blood pressure and recurrent hospitalizations rather than assuming that CKD alone is responsible.

It is also important to avoid medications that can further impair kidney function, particularly non-steroidal anti-inflammatory painkillers, unless specifically advised by her doctor.

Nothing in what you've shared suggests you need a new doctor right now. But if she needs a second opinion from an experienced nephrologist is a reasonable next step both for reassurance and to get a fresh look at her overall management.

I would recommend following up with the results of the suggested investigations, as they may provide important clues regarding the cause of her recurrent admissions and recent decline in kidney function.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.

Medically reviewed by iCliniq medical review team
Published At June 12, 2026
Reviewed At July 2, 2026

Education:

MBBS

Professional Bio:

Dr. Murugan Sivalingam is a highly experienced nephrologist and internal medicine specialist dedicated to delivering comprehensive kidney care and managing complex medical conditions. He combines advanced expertise with compassionate patient care, focusing on personalized treatment plans and improving overall health outcomes.      

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Murugan Sivalingam is a highly experienced nephrologist and internal medicine specialist dedicated to delivering comprehensive kidney care and managing complex medical conditions. He combines advanced expertise with compassionate patient care, focusing on personalized treatment plans and improving overall health outcomes.      

This doctor is not available for online consultations on the platform anymore.

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