concerned over rising creatinine level.

Posted by rans @rans, Dec 11, 2018

Labs showed level increased from 1.5 to 1.7. All my other numbers were ok. GP took me off my BP ( lisinopril ) med for one week and then retest.( pending

More info on ACE inhibitors and creatiniine:
https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1751-7176.2008.00023.x
https://www.clinicaladvisor.com/advisor…/creatinine-increase…ace-inhibitor/…/11800…
https://www.aafp.org/afp/2002/0801/p461.html

Liked by cehunt57

@trishanna

@marvenjsturing. Realized my nephrologist reduced my Lisinopril from 10 mg to 5 mg. Told me it was because of a change in my blood pressure – now, I'm not so sure. Anyhow, after almost a year, bp is 140/68. Cr is 1.0+/-. Think you might want to question your doctor. Hope this helps.

Jump to this post

I am on a low dosage of lisinipril – 2.5 mg a day. My nephrologist said she prescribed it to slow down the deterioration of my kdneys.

@kamama94

@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/

Jump to this post

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.

Liked by cehunt57, kamama94

@kamama94

@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/

Jump to this post

Good research. It always seems like a balancing act.

Liked by cehunt57, sissieann

@predictable

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.

Jump to this post

One size often does not fit all. Right now my GP is keeping me off lisinopril for 7 days to see if it has any effect. BP is holding 137/85, 4th day. We will see what is the next step is if that has no effect

Liked by cehunt57, kamama94

@kamama94

@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/

Jump to this post

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!

Liked by cehunt57, kamama94

@marvinjsturing

I am on a low dosage of lisinipril – 2.5 mg a day. My nephrologist said she prescribed it to slow down the deterioration of my kdneys.

Jump to this post

Wow…your post got me thinking…BP out of control is bad on kidneys…so is my still high BP, now with “flutters”, causing MORE damage to my kidneys than taking lisp…which BTW kept my BP and heart very steady….interesting! Thanks for the post…I’ll let u know what my nep says after Christmas.

Retested after being off BP meds for a week. Creatinine dropped 1 point to 1.6. GP says that is not a real change from 1.7. ultrasound tomorrow.

Liked by cehunt57

@rans Fingers crossed!!

Liked by cehunt57, kamama94

@rans Fingers crossed here also. I think I'd like a drop from .7 to .6 on the theory that every little bit helps even if it IS only a little bit. Keep us posted.

Liked by cehunt57

@kamama94

@rans Fingers crossed here also. I think I'd like a drop from .7 to .6 on the theory that every little bit helps even if it IS only a little bit. Keep us posted.

Jump to this post

Results of ultra sound were inconclusive. I'm being referred to a kidney clinic. GP just doesn't seem very knowledgeable on the subject, maybe it's time for some self diagnosis. I'm leaning towards urine retention because of BPH.

Liked by cehunt57

@trishanna

@rans Fingers crossed!!

Jump to this post

Thanks for the crossed fingers.

Liked by cehunt57

@rans

Results of ultra sound were inconclusive. I'm being referred to a kidney clinic. GP just doesn't seem very knowledgeable on the subject, maybe it's time for some self diagnosis. I'm leaning towards urine retention because of BPH.

Jump to this post

It is a wise physician who recognizes his/her lack of knowledge in a particular area and refers you to a specialist. Please let us know what you find our at your appointment with the kidney clinic.

@colleenyoung

It is a wise physician who recognizes his/her lack of knowledge in a particular area and refers you to a specialist. Please let us know what you find our at your appointment with the kidney clinic.

Jump to this post

Will do.

Liked by cehunt57

@trishanna

Things to be concerned about keep popping up, don't they. I, too, take Lisinopril. Shall check this out, too.

Jump to this post

@ trishanna Speak to your Neph about ramipril. It is less harsh than Lisinopril'

Liked by cehunt57

Please login or register to post a reply.