Will med-induced glomerular filtration rate (GFR) rebound?

Posted by mjsmayo @mjsmayo, Aug 6 5:16pm

I have high blood pressure. On top of my regular blood pressure pill, my doctor had prescribed a new medication called Hydrochlorothiazide. I took it for only a week and my GFR dropped from 53 to 42.

I have now stopped taking it. Will my GFR go back up to 53 ?

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@mjsmayo Welcome to Mayo Clinic Connect!

You are asking about a "rebound" in your eGFR after stopping hydrochlorothiazide. That remains to be seen, honestly. There are several factors that can influence the reading, including but not limited to the following: your hydration level at time of blood draw, time of day, recent activity, weather, additional medications recent meals.

You will find that the majority of medical doctors will look at a trend of your blood results, not a single value. When do you have your next set of labs scheduled? Was it your doctor who stopped this new medication; what was his reasoning for starting it, then stopping it? What did he replace it with, if anything?

If you care to share a bit more about your kidney disease, the cause of it and how long you have been on this journey, I am happy to answer any questions you have!
Ginger

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I went on Bactrim for a UTI and my GFR dropped from 29 to 18. My kidney specialist took me off it about a week later and my GFR did rebound. Of course this is a different medication and everyone is different but I’m hoping that you also had an acute episode that can be overcome. Wishing you the best.

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@gingerw

@mjsmayo Welcome to Mayo Clinic Connect!

You are asking about a "rebound" in your eGFR after stopping hydrochlorothiazide. That remains to be seen, honestly. There are several factors that can influence the reading, including but not limited to the following: your hydration level at time of blood draw, time of day, recent activity, weather, additional medications recent meals.

You will find that the majority of medical doctors will look at a trend of your blood results, not a single value. When do you have your next set of labs scheduled? Was it your doctor who stopped this new medication; what was his reasoning for starting it, then stopping it? What did he replace it with, if anything?

If you care to share a bit more about your kidney disease, the cause of it and how long you have been on this journey, I am happy to answer any questions you have!
Ginger

Jump to this post

Hi Ginger:

The reason my doctor started this medication is because my blood pressure reaches over 140 sometimes although half the time it is in the 120 and 130 range. It appears that the doctor wants my blood pressure to be below 140 at all times. I have been taking nifedipine for over 30 years.

I started this new medication on 7/29 and had a blood draw on 8/5. That’s when I discovered that my eGFR went from 53 to 42. My creatinine has also increased. My potassium went down but glucose went up.

On top of all these problems, I have a rash on my face with blisters even though I apply SPF 55 sunscreen daily.

I have informed my doctor of all these problems as well as photos of my face with rash and blisters. She is aware that I do not want to continue with this medication. I am awaiting her reply.

REPLY
@gingerw

@mjsmayo Welcome to Mayo Clinic Connect!

You are asking about a "rebound" in your eGFR after stopping hydrochlorothiazide. That remains to be seen, honestly. There are several factors that can influence the reading, including but not limited to the following: your hydration level at time of blood draw, time of day, recent activity, weather, additional medications recent meals.

You will find that the majority of medical doctors will look at a trend of your blood results, not a single value. When do you have your next set of labs scheduled? Was it your doctor who stopped this new medication; what was his reasoning for starting it, then stopping it? What did he replace it with, if anything?

If you care to share a bit more about your kidney disease, the cause of it and how long you have been on this journey, I am happy to answer any questions you have!
Ginger

Jump to this post

Hello again :

I plan to schedule another lab draw a week or so after I stop this new medication

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@ldrlaw

I went on Bactrim for a UTI and my GFR dropped from 29 to 18. My kidney specialist took me off it about a week later and my GFR did rebound. Of course this is a different medication and everyone is different but I’m hoping that you also had an acute episode that can be overcome. Wishing you the best.

Jump to this post

Hi @ldrlaw

Thank you very much for the encouraging news. I am keeping my fingers crossed that my GFR will bounce back and my creatinine will become normal again.

REPLY
@mjsmayo

Hi Ginger:

The reason my doctor started this medication is because my blood pressure reaches over 140 sometimes although half the time it is in the 120 and 130 range. It appears that the doctor wants my blood pressure to be below 140 at all times. I have been taking nifedipine for over 30 years.

I started this new medication on 7/29 and had a blood draw on 8/5. That’s when I discovered that my eGFR went from 53 to 42. My creatinine has also increased. My potassium went down but glucose went up.

On top of all these problems, I have a rash on my face with blisters even though I apply SPF 55 sunscreen daily.

I have informed my doctor of all these problems as well as photos of my face with rash and blisters. She is aware that I do not want to continue with this medication. I am awaiting her reply.

Jump to this post

@mjsmayo Good for you to wait until you hear from your doctor about her ideas. Remember, you have the right to give your thoughts, also, on the situation. That is being proactive in your care. If you haven't yet, take some time to document the symptoms you are experiencing, including time of day, last meal eaten when, activity, etc. See if you notice a pattern yourself.

My blood pressure has been fluctuating quite a bit, too, recently. Seeing that I just had surgery 6 days ago to place a peritoneal dialysis catheter, plus being an active blood cancer patient on chemo since last August, I am attributing a lot to that. Each morning I take my vitals. Blood pressure is taken 3 times in the course of a half hour, to get a reading that best reflects my status for that point of the day. While my doctors would like to see my BP under 130 actually, there are just so many factors that play into it. For me to expect that is a pipedream, in my opinion! So I do the best I can with moderate exercise, healthy eating [especially low sodium!], hobbies that help relieve stress, medication compliancy at all times.

I will be interested to hear what guidance she gives you!
Ginger

REPLY
@gingerw

@mjsmayo Welcome to Mayo Clinic Connect!

You are asking about a "rebound" in your eGFR after stopping hydrochlorothiazide. That remains to be seen, honestly. There are several factors that can influence the reading, including but not limited to the following: your hydration level at time of blood draw, time of day, recent activity, weather, additional medications recent meals.

You will find that the majority of medical doctors will look at a trend of your blood results, not a single value. When do you have your next set of labs scheduled? Was it your doctor who stopped this new medication; what was his reasoning for starting it, then stopping it? What did he replace it with, if anything?

If you care to share a bit more about your kidney disease, the cause of it and how long you have been on this journey, I am happy to answer any questions you have!
Ginger

Jump to this post

Actually, I can’t be sure that the decrease in EGFR is because of the new medication hydrochlorothiazide since there is a month between my lab draws. I am only guessing that is the reason in that the gfr went down so much so quickly and the new medication is the only change that was made in my life during that time period.

I will know more when I stop taking the medication and do another blood draw.

REPLY
@gingerw

@mjsmayo Welcome to Mayo Clinic Connect!

You are asking about a "rebound" in your eGFR after stopping hydrochlorothiazide. That remains to be seen, honestly. There are several factors that can influence the reading, including but not limited to the following: your hydration level at time of blood draw, time of day, recent activity, weather, additional medications recent meals.

You will find that the majority of medical doctors will look at a trend of your blood results, not a single value. When do you have your next set of labs scheduled? Was it your doctor who stopped this new medication; what was his reasoning for starting it, then stopping it? What did he replace it with, if anything?

If you care to share a bit more about your kidney disease, the cause of it and how long you have been on this journey, I am happy to answer any questions you have!
Ginger

Jump to this post

Ginger, thanks for the helpful information. Regarding factors that may affect eGFR testing results, how do that affect it? Is it better to be well-hydrated at the time of the test? Better or best time of the day of the test? More activity or less prior to test? Maybe wait to take meds until after test? Not eat at all or not eat certain things. Just wondering. Thanks.

REPLY
@paul55

Ginger, thanks for the helpful information. Regarding factors that may affect eGFR testing results, how do that affect it? Is it better to be well-hydrated at the time of the test? Better or best time of the day of the test? More activity or less prior to test? Maybe wait to take meds until after test? Not eat at all or not eat certain things. Just wondering. Thanks.

Jump to this post

@paul55 When we are dehydrated, our whole system reacts in specific ways. You can visually see that with the color of our urine. Good hydration will show a light yellow, the darker the color, the more concentrated. While I am on a 2 liter [about 64 ounce] restriction per day, I have to spread it out in that 24 hr period. Difficult to do in the heat of summer!

For me, I typically fast before any bloodwork, and try to schedule it early in the morning. Then treat myself to breakfast! Recently a tech at my cancer center told me to be nicely hydrated the evening before the draw, as it makes getting any sample easier on the veins. Oh, and do not make a fist at the draw; it affects a few factors with the muscle contraction. Who knew?! I keep to my regular activity schedule. Not too sure about the meds, but I do keep to my regular time to take them, seeing that is early morning.

Does this help answer your question?
Ginger

REPLY
@gingerw

@paul55 When we are dehydrated, our whole system reacts in specific ways. You can visually see that with the color of our urine. Good hydration will show a light yellow, the darker the color, the more concentrated. While I am on a 2 liter [about 64 ounce] restriction per day, I have to spread it out in that 24 hr period. Difficult to do in the heat of summer!

For me, I typically fast before any bloodwork, and try to schedule it early in the morning. Then treat myself to breakfast! Recently a tech at my cancer center told me to be nicely hydrated the evening before the draw, as it makes getting any sample easier on the veins. Oh, and do not make a fist at the draw; it affects a few factors with the muscle contraction. Who knew?! I keep to my regular activity schedule. Not too sure about the meds, but I do keep to my regular time to take them, seeing that is early morning.

Does this help answer your question?
Ginger

Jump to this post

I was told it is hard on the kidneys to drink a lot at one time, so I usually take 4 or 5 sips through a straw in probably 15 minutes or half hour.

Thanks for the information to be hydrated before a blood draw.

REPLY
@mjsmayo

Actually, I can’t be sure that the decrease in EGFR is because of the new medication hydrochlorothiazide since there is a month between my lab draws. I am only guessing that is the reason in that the gfr went down so much so quickly and the new medication is the only change that was made in my life during that time period.

I will know more when I stop taking the medication and do another blood draw.

Jump to this post

Hi MJS, how are you doing? Has you GFR improved? Would love to get an update and any insights you may have learned.

REPLY
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