Should I be worried about the side effects of diuretics on kidneys?

Patient's Query

Hi doctor,

Three months ago, I had a heart attack. Then, I went through angioplasty with stenting. Post heart attack, I was diagnosed with moderate systolic HF with EF at 35%. Currently, I am on Clavix, Rozucor 10 mg, Tide 5 mg, Metocard-XL, Planep 25 mg and Telma 20 mg. I am improving well. My EF has improved to 40% on first follow up after a month. I have lost about 6 kg to 7 kg weight in the last three months. I am under excellent diet control and daily walking about 70 minutes. I gave up smoking completely. One week back I had my blood checked for various profiles and regarding which I have a few queries.

My lipids are on the low side that is total cholesterol 123, HDL 23 and LDL 61. I was on Rozucor 40 for the first one month and then I am on Rozucor 10 mg. Am I below the target range? If yes, can I get the dose reduced further? My uric acid is high 8.1. I read that this may happen due to hypertensive medicines, particularly diuretics and ARBs. Is the high uric acid a point of concern? Should I consult my treating doctor? My kidney profile with sodium and potassium are within limits.My BP is constantly on the lowest average of 90/55 mmHg with heart rate of 65 to 72. Can I reduce my medicines, particulary diuretics? I am worried about the side effects of diuretics on the kidney. My alkaline phosphatase is at 131, just 3 points above the higher limit of 128. Is it fine to have this reading post myocardial infarction? Please explain.

Answer

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine

Hi,

Welcome to icliniq.com.

I appreciate your concerns. After thorough review of your health query, I want to answer those questions.

Do not be overconscious regarding the issue of the lipid profile. It seems to be fine to go with this.

Keep taking healthy diet. Your profile is not too low to worry about. It will get better with diet improvement.

Avoid taking high protein diet and remain physically active. It will take your levels of uric acid down to normal limits.

It is not so urgent to visit your doctor and on your visit you may ask your physician about medication review if possible (keeping your whole health scenario in mind).

Yes, you should call your treating physician for adjustment of dosage, especially diuretics if possible. Actually, the reason for your high dosage diuretics is because we want to take the workload off of your failing heart with compromised EF (ejection fraction).

Alkaline phosphatase being 131 (especially in this scenario) is not a big concern. There is no need of any immediate medical intervention. It is insignificant and non-specific.

For further doubts consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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