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concerned over rising creatinine level.
Kidney & Bladder | Last Active: Mar 12, 2019 | Replies (49)Comment receiving replies
@martin Jensen and everyone wondering about Lisinopril:
I've read and been told that ACE-inhibitors like Lisinopril can protect the kidney from renal hypertension (relieving glomerular pressure by lowering blood pressure, especially in diabetics.) But it also can decrease GFR because it blocks a protective mechanism which occurs in the kidney to maintain GFR.
So it seems to be a tossup - protect the kidney and improve function by controlling blood pressure vs protect the kidney's GFR status which MIGHT be impaired by the blood pressure med.
This is not medical advice or diagnosis, just my opinion based on my nurse's training as well as on fairly recent research done on my own.
I'm guessing my neph and primary both told me to stay on Lisinopril for now because they believe the benefits of lowering my blood pressure outweigh the risks of lowering GFR, especially since my GFR is above 30.
I'm also guessing that if my GFR declines too much we will have to seek alternatives.
Once again, these are just my own guesses and opinions based on a small amount of research.
Here are some websites with more information on the subject:
https://www.mdedge.com/clinicianreviews/article/134719/nephrology/when-discontinue-raas-therapy-ckd-patients
tmedweb.tulane.edu/pharmwiki/doku.php/ace_inhibitor_pharmacology
https://universityhealthnews.com/topics/heart-health-topics/3-ace-inhibitor-side-effects-should-you-seek-out-alternatives/
Replies to "@Martin Jensen and everyone wondering about Lisinopril: I've read and been told that ACE-inhibitors like Lisinopril..."
Good research. It always seems like a balancing act.
Thxs for checking! Since I’ve been off lis my BP has been elevated along with, feels like vent fib, but doesn’t show on EKG..,
I’ll go back and look at past labs to compare..I see my nep 12/26 and we will hv a chat...lol
Thanks to all for input! So valuable....truly appreciate everyone!
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In research, variables are crucial and worthy of careful attention. Reviewing the referenced materials, I found too many variables to make any clear judgments about hazards from ACE inhibitors. One variable of note is the lack of sound clinical research and a surfeit of articles authored by one or two doctors. One article emphasized that ACE inhibitors are "associated with" kidney problems of diabetics, not the cause of them. Another warned of concern for the possibility of hyperkalemia (which struck close to me personally, since I am congenitally hypokalemic and am treated with potassium enhancing medication). I found one reference to the importance of dealing with creatinine levels and watching it over time, but it seemed that kidney failure was related to stenosis of the arterioles in the kidneys more than their dissipation. So I will continue with my ACE-heavy treatment and wait until my next regular appointment with my nephrologist to initiate a discussion of the issues raised here. Perhaps others will hesitate to draw personal conclusions based on experiences of one patient or one doctor on the issues involved.