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

You asked if low diastolic readings accompanied CKD. I should be the last person to respond as I only was diagnosed with stage 3B a couple of months ago. Shortly after the doctors office called telling me that my numbers had dropped from 43 to 35 in a very short period of time, just coincidentally I had two blood tests in a short period of time, I got out of my chair and felt very very dizzy. Happen to have an old blood pressure monitor from years ago for a totally different reason. I dug it out and found what I thought were dangerously low numbers. Probably not as bad as I thought but they were well below the 90/60 acceptable range . Doctor immediately took me off of Jardiance and lisinopril 2.5 MG. The lisinopril was not for hypertension, but to help with kidneys. I had been on that for years and years. Well, my blood pressure returned to normal before there could have been any effect from removing the meds. And I only had one or two instances shortly there after where my blood pressure showed hypotensive reading. So for what it’s worth, kidney disease in my case seems to have caused the temporary episodes of very low blood pressure. Best luck!

Julie, I read your recent post, and I am reminded of some similarities that I experienced with food and appetite before my organ transplant. My story/health history is different: I had end stage liver failure that caused acute kidney failure, and I was in dialysis treatment until transplant. I was 60 at the time. However, I remember that I had no appetite, no taste, dry mouth, and absolute no desire to eat or do anything at all. I had arrived at Mayo via air transport from ICU in another state with a feeding tube, but I don't know when or who put it in! Neither does my husband. Anyway, the doctor at Mayo said that if I thought I could eat, he would remove it. So I was given some kind of bottled shakes, similar to Ensure. Just seeing the nurse deliver it made me want to gag. I used to get angry at my husband who 'made' me drink it by reminding me that the doctor said he would reinsert the feeding tube if I didn't get the nutrition myself with the shakes. Yuck! Grrr!
Eventually when I was able to eat more soft solid foods. I found that cinnamon or a squeeze of lemon gave it a taste that was more enjoyable. I couldn't tolerate sweets, but enjoyed applesauce, some fruits as your husband is enjoying watermelon and fruit bowls. Another issue was a dry mouth that made dry foods like toast or meat almost like chewing on sawdust. However mashed potatoes and sometimes oatmeal were tasty. Milkshakes, ice cream, and occasional jello were my favorites.
I can emphasize with your husband. My thoughts and prayers are with him. I hope that today is a good one 🤍

Today when I talked to him it was a down day and he was mad at me for not insisting they let him go home. He did discover they would give him chocolate milkshakes so that was his lunch.

It is almost like his body is shutting down gradually. He still apparently has low BP when he goes from sitting to standing. And from laying flat to sitting - at least from what he was describing. But in one position it is normal - or fairly normal (diastolic on the verge). That is with medication that is supposed to raise the blood pressure. With out that I think it would be really low.

They have commented that mostly he will only eat the fruit bowls and watermelon. I had them bring him a tuna melt and he said he did eat most of one half. Keeps insisting, even at home, that he has no apatite and simply can't eat.

Aah, Julia, it's wonderful to hear about your visit with Scott - and that he now agrees with you and Robin about his Dad's need for more care. Bill sure is a "sneaky Pete" about his condition, isn't he? 😉

But like you, I am worried about the rapid weight loss, and I rather doubt his report of eating more. Twenty pounds in 3 weeks is a pound a day - unless he had a fierce amount of fluid retention when he went to the hospital, it translates to about zero net calories intake per day. Perhaps you can ask about either holding off on release until he begins to regain some weight, or ask for a STAFF food diary - what was offered and what was eaten - without his knowledge so he won't toss it in the toilet & flush (been there and seen it.)

Is it possible to discuss this with whomever is managing his rehab?
Wishing you a good week. Sue

Had a wonderful visit with Scott. Robin, Scott and I went to see Bill yesterday and it was one of his 'good' days! The physical therapy had helped so much! His posture was better and he was able to get off the bed and standing - with only some effort (also putting on a show for Scott). He even said he was eating a little bit more than fruit. In less than 3 weeks he has gone from 182 to 162! He hadn't been eating much at home but more then in the hospital/NH.

Scott he could breath now that he saw him and knew he wasn't going to drop dead any second.

What Scott didn't see was after we left we went back as the nurse was going to take his BP (119/67!) and I stepped back in the room first. Bill was collapsed on the bed. As soon as he saw me he reverted to being 'great' so that is what Scott saw. I didn't mention it.

Scott is so glad that I didn't listen to his Dad and bring him home before they think he is ready (before he was going to come 'rescue' his Dad).

So a good weekend.

Good idea

Julie, I have a suggestion regarding your son's visit. If he insists he will try to get Dad out of care early, explain to him that he will need to come and be his 24/7 caretaker for 72 hours - alone. And that you and your daughter will be leaving the house so he can get the "full experience."

My brother-in-law's family recently needed to move Mom to residential hospice at the end of life as having 2 people at a time with her 24/7 wasn't enough to keep her safe. Of course the 2 least-involved daughters objected. My sister & b-i-l told them "you and your husbands are retired, just move in and take over her care." Of course they had 900 reasons why they couldn't, so she contentedly stayed in hospice until the end.

Praying all will go well with the visit.
Hugs!
Sue

My mom is 95 and has Alzheimer's - in dementia times - she would never eat food and someone had to remind her about the food , basically she needed reminders (which are counted as assists and needed least 20 to 25 assists in a day). On few occasions there were pleasant surprises too - food is consumed not sure if they liked the food are so .. totally random experiences. (next time the same food was not being eaten)

I have tried to read a lot on this subject too .. it is sometimes difficult to comprehend the human mind as times moves ahead .

He has been refusing to eat anything accept watermelon and fruit cups. At home we would put food in front of him and he would eat some while protesting. At the hospital and NH they haven't been able to convince him to eat - I told them to just bring him food - he did say he was going to try the chicken leg. Along with CKD, other health problems he has mild dementia. I'm also never sure he is telling me the truth about his eating, BP taken there, etc. Although staff said he will only accept fruit and has a major desire for watermelon.

He has always drunk a lot of water - has a large bottle of water with him constantly. That morning he had two full bottles before his appointment. And, of course I had water in my purse for him.

Son Scott called this morning to say he is on his way - a last second surprise. Bill will put a lot of pressure on Scott to 'spring' him. Since he is finally showing some progress I told Scott to be strong. But Bill is really good about putting on an act and Scott has always done as his Dad directed. Could be a rough two days of visits.

Could very well be is that he is severely dehydrated

Dehydration causes incorrect GFR values to be displayed when blood test is done, - Hence it is always advisable to drink a lot of water before going for blood test.

I drink 16 to 18 ounces of water prior to my early morning testing fasting.

Also when you are hospitalized they right away administer the saline drip into your blood system which addresses any dehydration .. so GFR of 67 is a good number. Just make sure Bill somehow drinks lot of water before going in for the next test.

Medicare clearly tells you to look for a kidney donor when GFR is below 20 and when GFR is hovers near 10 then you are pretty much in the dialysis zone.

I am not a doctor but I personally feel Bill is far far away to even think about Dialysis, just make sure he is hydrated and stays on a healthy diet.

Regards