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?).

Interested in more discussions like this? Go to the Kidney & Bladder group.

If it isn't one thing it is another! This morning Bill had me rub his hands and I noticed that the palm of his hands are red and seem to be slightly swollen. Also his stomach seems larger – extended – very soft to the touch – has been this way for awhile – only part of him showing overweight. When he is on his side it sags downward. Can these be CKD symtoms? Or normal and I just haven't noticed? Over the last couple of years he has gone from 230 to 180 without working on it. Sorry to be a bother but he doesn't want me to check with doctor and I'm just not sure what is happening or what to look for.

REPLY

Hi @billchitwood, I am sorry that Bill is dealing with so many issues. I thought I would share some information that may be helpful for you.

Low Diastolic Blood Pressure and Chronic Kidney Disease Are Associated With Increased Mortality: https://jamanetwork.com/journals/jama/article-abstract/1741818

Too-low diastolic blood pressure can be deadly for CKD patients: https://www.sciencedaily.com/releases/2013/08/130819185346.htm

Chronic kidney disease: https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

Have you asked his physician about his stomach being distended?

REPLY

He hasn't wanted to have me call his doctor – he already told him that he only wants palliative care if it comes to that. I just don't know what to expect or how to help him. Last blood test was mid November of last year. Thank you for the links.

REPLY
@billchitwood

If it isn't one thing it is another! This morning Bill had me rub his hands and I noticed that the palm of his hands are red and seem to be slightly swollen. Also his stomach seems larger – extended – very soft to the touch – has been this way for awhile – only part of him showing overweight. When he is on his side it sags downward. Can these be CKD symtoms? Or normal and I just haven't noticed? Over the last couple of years he has gone from 230 to 180 without working on it. Sorry to be a bother but he doesn't want me to check with doctor and I'm just not sure what is happening or what to look for.

Jump to this post

Hi @billchitwood
Red Palms can be an indication of Liver Disease. Do a search of “red palms” to read more.

REPLY

I did and it can also be related to low Thyroid. Some years ago he was put on med for low thyroid – just in the past year his blood test showed low TSH at .31 – so apparently the med isn't helping as much. When they did a knee reflex test on him he had no reaction in either knee. A few years ago was diagosed with a valve problem in his right leg. Treated for years for high BP, which was kept in a very good range, until recently when it has dropped, especially the diastolic. Also treated for gout, which he has suffered from since he was in his 30s, but now kept under control with med (actually no attacks after right hip replaced in 1999). Has always had sleep problems and taken sleeping pills. On anti-stress meds as well. Some confusion and often doesn't make it to the bathroom in time! Complete fatigue. Trip to and from the bathroom completely wipes him out and a shower is even worse. Seems like every day something new – now it is an itchy back. Has also had chronic back pain in the kidney area for some time. In the past two months has chronic diarrhea. Last blood test in Nov of last year showed him at GFR 55 while the one in July of 2020 showed GFR of 42.7 (likes to jump back and forth). Thank you for your help and just letting me ramble. Julie

REPLY
@billchitwood

He hasn't wanted to have me call his doctor – he already told him that he only wants palliative care if it comes to that. I just don't know what to expect or how to help him. Last blood test was mid November of last year. Thank you for the links.

Jump to this post

Hi, If Bill is interested in palliative care, I might suggest you inquire about a palliative care consult. Palliative care is not specific to end-of-life care. It is better name symptom management care. Clearly Bill is having symptoms that are related to his health conditions. A palliative care doctor or symptom management nurse can help.

Do you know how you might contact a palliative care specialist?

REPLY

I have no idea how one would find someone and gather that Medicare doesn't cover it (unless end of life). Sort of up in the air about everything.

At the moment we are keeping any pain under control. Stranges thing is how his Blood presure has dropped – today 114/53. Has been constantly low the past few weeks (wasn't really monitoring it before as meds keep it at a really good level. Thank you.

REPLY
@colleenyoung

Hi, If Bill is interested in palliative care, I might suggest you inquire about a palliative care consult. Palliative care is not specific to end-of-life care. It is better name symptom management care. Clearly Bill is having symptoms that are related to his health conditions. A palliative care doctor or symptom management nurse can help.

Do you know how you might contact a palliative care specialist?

Jump to this post

@colleenyoung I got so.e I formation I'd like to post in the Champion page IUCLAscientist found information for osteoporosis Silicon,along with LLysin ,Strontium but I don't know how to post it I have the article but again not sure of how to post it Can you help me with this information

REPLY
@lioness

@colleenyoung I got so.e I formation I'd like to post in the Champion page IUCLAscientist found information for osteoporosis Silicon,along with LLysin ,Strontium but I don't know how to post it I have the article but again not sure of how to post it Can you help me with this information

Jump to this post

Hi lioness,
Please post the information to the most appropriate osteoporosis discussions in the Bones, Joints & Muscles group (https://connect.mayoclinic.org/group/arthritis-and-joint-conditions-268850/)

Perhaps this discussion:
– Osteoporosis treatment or strontium citrate? https://connect.mayoclinic.org/discussion/osteoporosis-treatment-or-strontium-citrate/

REPLY
@billchitwood

I did and it can also be related to low Thyroid. Some years ago he was put on med for low thyroid – just in the past year his blood test showed low TSH at .31 – so apparently the med isn't helping as much. When they did a knee reflex test on him he had no reaction in either knee. A few years ago was diagosed with a valve problem in his right leg. Treated for years for high BP, which was kept in a very good range, until recently when it has dropped, especially the diastolic. Also treated for gout, which he has suffered from since he was in his 30s, but now kept under control with med (actually no attacks after right hip replaced in 1999). Has always had sleep problems and taken sleeping pills. On anti-stress meds as well. Some confusion and often doesn't make it to the bathroom in time! Complete fatigue. Trip to and from the bathroom completely wipes him out and a shower is even worse. Seems like every day something new – now it is an itchy back. Has also had chronic back pain in the kidney area for some time. In the past two months has chronic diarrhea. Last blood test in Nov of last year showed him at GFR 55 while the one in July of 2020 showed GFR of 42.7 (likes to jump back and forth). Thank you for your help and just letting me ramble. Julie

Jump to this post

His diastolic continues to be in the 59 to 44 range every day. He almost fell the other night (is using his walker a little more now). Admitted to having the 'wobblies'. The other morning showed 3 large red/purple purpura? on his rump with no idea how it happened. A normal large unexplained bruise on his arm. Would these be signs that the CKD is progressing? Or something else entirely? Again, he is resisting doctor visit.

REPLY
@billchitwood

His diastolic continues to be in the 59 to 44 range every day. He almost fell the other night (is using his walker a little more now). Admitted to having the 'wobblies'. The other morning showed 3 large red/purple purpura? on his rump with no idea how it happened. A normal large unexplained bruise on his arm. Would these be signs that the CKD is progressing? Or something else entirely? Again, he is resisting doctor visit.

Jump to this post

I fell a couple of times in the days before my husband took me to the ER. I never expected acute kidney failure because we were focused on liver failure. When I got to the ER my blood pressure and pulse were extremely low. So was my temperature. I was not aware of much that was going on around me. My husband had to answer all of the questions and provide health information. I was given warmed IV fluids because I was dehydrated. They even used heated IV solutions for transport to the regional hospital. This was a complete surprise and most unexpected. Fortunately I was admitted to the ICU at the hospital where I was waiting for a liver transplant (prior to being sent to Mayo) so we were already familiar with the location. That helped my husband a lot.
I am aware that your husband does not want to see a doctor or seek treatment. I believe that is his right. I am, however, concerned for you. What does he want you to do if he fails? As uncomfortable as it is, please have a conversation with him. Tell him you need to call the doctor because ‘you need to know’ what to do. You love him and he loves you – let that be the source of strength that guides you. This is a condition that affects both of you. I am holding you and him in my thoughts.

REPLY

Did you have the liver transplant? You have gone through so much. Prayers with you and your husband.
Bill has told the family he does not want anything done to prolong life – that when he is ready to go to let him. A little while ago he was telling me that he thought he had pills in his hand – but didn't. Felt better after eating Rocky Road for lunch. He is on a major sugar kick – I do try and get fruit and veggies into him as well. Family is in accord to try and keep him as pain free as possible and let him enjoy whatever he wants. At 88 with quite a few health problems quality is more important for him. I just try to figure out by research to try and understand what he is going through. A blood test would tell a lot, but again, he doesn't want one. Just being able to discuss things is a tremendous relief.

REPLY
Please sign in or register to post a reply.
  Request Appointment