Is Low Diastolic Blood Pressure common with Stage 3 or 4 CKD?

Posted by Julie Chitwood @billchitwood, Jul 29, 2021

Bill has CKD. Has been on Atenolol for decades and it has keep his BP at a great range. However, we recently noticed that his BP has been dropping really low sometimes during the day, especially the diastolic (in 50s, 40s, and one day 34 diastolic. Then later it will go back to fairly normal or at least 114/60. Is this common with Stage 3 or 4 CKD? He has also been suffering from chronic diarrhea lately (once or twice a day a couple of times a week). He is 88. Doesn't want to go to doctor and have more meds as he is already on 8 prescriptions and several OTC. Has been suffering from fatigue for several years that doctors indicate they can't do anything for. Has an enlarged prostate (which coud have brought on the kidney problem along with old age?).

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@billchitwood

Question - is it normal for a doctor with a CKD not to order urine tests when doing blood tests? I would think that the two would almost go together, however Bill rarely has a urine test ordered. I think last full one was in early 2020. He did have a blood test done this Fall (his GFR number had fallen again).

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UFR is standard in all CKD test

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@nimalw

UFR is standard in all CKD test

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I've been surprised that his doctor hasn't ordered them more often. But Bill did tell him that he didn't want any treatments, including dialysis if it came to that. So maybe that is why. Next time I'll ask lol. His urine looks normal although it has bubbles around the sides.

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@billchitwood

I've been surprised that his doctor hasn't ordered them more often. But Bill did tell him that he didn't want any treatments, including dialysis if it came to that. So maybe that is why. Next time I'll ask lol. His urine looks normal although it has bubbles around the sides.

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Has he got a protein leak ??? You got to know that by now

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@nimalw

Has he got a protein leak ??? You got to know that by now

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How would a protein leak be determined? He has bounced between Stage 3 a and b and back to low a since first told about it in Jan 2020. He previous doctor never said anything and to be honest I didn't know to pay attention to a GFR. He had a test which showed a vascular insufficiency and was told to wear compression stocking on right leg. Dr in AZ said he didn't think he needed them as his leg was constantly elevated by his recliner and the stocking was bothering him in summer heat (getting lots of bruising/sores on both legs). Lately has been having more and more problems with memory issues.

Thank you.

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@billchitwood

How would a protein leak be determined? He has bounced between Stage 3 a and b and back to low a since first told about it in Jan 2020. He previous doctor never said anything and to be honest I didn't know to pay attention to a GFR. He had a test which showed a vascular insufficiency and was told to wear compression stocking on right leg. Dr in AZ said he didn't think he needed them as his leg was constantly elevated by his recliner and the stocking was bothering him in summer heat (getting lots of bruising/sores on both legs). Lately has been having more and more problems with memory issues.

Thank you.

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So hes been diagnosed then . Protien leak can be urine test called Urine full report.

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@nimalw

So hes been diagnosed then . Protien leak can be urine test called Urine full report.

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We moved back to AZ from KY in Dec 2019. In Jan 2020 a blood test was run and a second one about a month later both showing GRF in the Stage 3 range - lower in the second one to almost b level. At one point he dropped into b level then back into a (different labs). A urine test was done on the second test showing some protein in the urine I believe. (Bill turned 87 in April of that year). He has had health issues for quite a few years and been on medication for most of them.

Has had very mild cognitive issues for some years. Lately they have gotten worse and this past week a lot worse comparatively. He won't go out. Doesn't want people to visit. Has almost no appetitive and will basically only eat sweet things. Rarely will eat meat any more. Has a swallowing problem (valve). They wanted him to do tests to confirm what was happening but he refused.

The other day he had a realtor over and signed up to sell our home as he wants to move again. I managed to talk him out of that - at least for the moment! Long range planning is beyond me as to guess work of what might be in store.

Last time Dr saw him told daughter we probably should consider a nursing home (out of the question). He didn't indicate why he thought so (I had taken Bill down the hall for a blood test - didn't realize a urine test hadn't been ordered). Bill can do all the activities of daily living so it isn't that. I keep feeling he knows something that I don't???

With hearing problem I can't do a phone conversation and he doesn't do email (rats).

Also when he did the reflex knee test Bill has no reaction whatsoever in either leg. Gets sores really easily and bleeds.

Every day seems to get more interesting. And more 'guess work'.

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@billchitwood

We moved back to AZ from KY in Dec 2019. In Jan 2020 a blood test was run and a second one about a month later both showing GRF in the Stage 3 range - lower in the second one to almost b level. At one point he dropped into b level then back into a (different labs). A urine test was done on the second test showing some protein in the urine I believe. (Bill turned 87 in April of that year). He has had health issues for quite a few years and been on medication for most of them.

Has had very mild cognitive issues for some years. Lately they have gotten worse and this past week a lot worse comparatively. He won't go out. Doesn't want people to visit. Has almost no appetitive and will basically only eat sweet things. Rarely will eat meat any more. Has a swallowing problem (valve). They wanted him to do tests to confirm what was happening but he refused.

The other day he had a realtor over and signed up to sell our home as he wants to move again. I managed to talk him out of that - at least for the moment! Long range planning is beyond me as to guess work of what might be in store.

Last time Dr saw him told daughter we probably should consider a nursing home (out of the question). He didn't indicate why he thought so (I had taken Bill down the hall for a blood test - didn't realize a urine test hadn't been ordered). Bill can do all the activities of daily living so it isn't that. I keep feeling he knows something that I don't???

With hearing problem I can't do a phone conversation and he doesn't do email (rats).

Also when he did the reflex knee test Bill has no reaction whatsoever in either leg. Gets sores really easily and bleeds.

Every day seems to get more interesting. And more 'guess work'.

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I wouldn't worry about leak at this stage of Bill's life.
Best is to keep him comfortable and happy for what ever time thats left . After all we all have to Die some day !

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Bill had me get him a Kardia Mobile (checks for 2 forms of AFib. For the most part his test shows normal - although his results seem to be all over the place. Years ago he was told he has arrhythmia and quite often he pounds his chest as he says his heart seems odd. I'm not sure that the Kardia results really show what is happening, although he is happy to see the 'normal' so maybe that is enough.

Has anyone else found the Kardia of use? He also uses an Oxygen meter and normally runs between 90 and 93. Heart beat tends to be in mid 50s.

Will be a quiet Christmas. Wishing everyone a great holiday season and a much better 2022!

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@nimalw

I wouldn't worry about leak at this stage of Bill's life.
Best is to keep him comfortable and happy for what ever time thats left . After all we all have to Die some day !

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Protein leakage can cause a lot of uncomfortable symptoms like swelling and severe fatigue. And at stage 3 can be treated with an ACE or ARB. Yes, we are all going to die, but might as well enjoy life feeling best as possible.

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@billchitwood

Bill had me get him a Kardia Mobile (checks for 2 forms of AFib. For the most part his test shows normal - although his results seem to be all over the place. Years ago he was told he has arrhythmia and quite often he pounds his chest as he says his heart seems odd. I'm not sure that the Kardia results really show what is happening, although he is happy to see the 'normal' so maybe that is enough.

Has anyone else found the Kardia of use? He also uses an Oxygen meter and normally runs between 90 and 93. Heart beat tends to be in mid 50s.

Will be a quiet Christmas. Wishing everyone a great holiday season and a much better 2022!

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Julie, you may be interested in taking part in this related discussion:
- Medical devices to monitor heart rhythm (i.e., Alivecor, KardiaMobile) https://connect.mayoclinic.org/discussion/kardiamobile/

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