← Return to Stage 3 chronic kidney disease (CKD): What specialists do I see?

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@predictable

Hi, @riveroaksfarm, welcome to Mayo Connect and this large community of people experiencing one or another of untold numbers of maladies, medical responses, second opinions, and after-care prospects. I'm intervening here because of similarities with your situation and uncertainties, and you might find something worthwhile.

I am CKD stage 3 with hypertension, but not diabetic. I get treatment from an internist, a cardiologist, and a nephrologist. My nephrologist is captain of my care (so far as I am concerned) and often consults with an endocrinologist on kidney-affecting hormones. My cardiologist is interested mainly in my a-fib, which has me on Coumadin anticoagulant but without any symptoms.

My primary BP medication for 30 years has been one diuretic after another. Amlodipine lasted only a short time because of swelling in my extremities, a common and vexing side-effect. My diuretic now is Amiloride, a potassium-sparing medication that I need to maintain the right potassium level. I am also on Lisinopril (an ACE inhibitor related to your Losartan) and Carvedilol (a beta blocker related to your Metoprolol). These meds keep my BP pretty stable after years of raging up and down and up again. Diet and exercise are crucial factors also.

Altogether over those 30 years, doctors have experimented on me with some two dozen medications (I won't bore you with the details, only say that most were dropped after failing to do the job, but if you want to ask me about any specific med, I'll gladly respond). My nephrologist is unique in that she wasn't simply searching for a medication that would help -- she went after the cause(s) of my symptoms, and she found them in my DNA (my genetics).

Therein is my primary advice: Ask your medical team for tests under the new discipline known as Pharmacogenomics, which examines your DNA comprehensively to identify which medications are most likely to be effective, given your genetic makeup. If possible, insist on this, and get back to us if you want to proceed along this line and need some external contact information to access the tests. In the meantime, perhaps you can get your GP or your nephrologist to explain the risks you face taking your three primary medications. Get back to us any time if you think we can help.

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Replies to "Hi, @riveroaksfarm, welcome to Mayo Connect and this large community of people experiencing one or another..."

I am a 72 year old woman with CKD stage 3 I also have TBI so it’s difficult for me to put this in words. Your story sounds like mine I am going to ask my nephrologist for that knew testing. My pressure has been high for several years now been trying to get it down at times it is. Couldn’t stay on Amlodipine which did bring it down some. I’m now on ahydrolazine cordevilil Bennecar, I also have A Fib and diabetes but that is 6 so under control with the right food. I’m really concerned about my kidneys went down. I’m on a couple other meds but I am afraid to take all these with the side affects. I do get nausea and weight gain which I am obese already not good for health etc. help I am scared. I don’t know if these drs