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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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Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 19, 2022
In reply to @billchitwood "Bill was admitted to a skilled nursing home for therapy yesterday. One place wouldn't take him...." + (show)
@billchitwood

Bill was admitted to a skilled nursing home for therapy yesterday. One place wouldn't take him. Our choice said yes and then declined him (worried about his behavioral problems even after being assured by Mayo that they were under control with his medicines and he had been no problem (other then he didn't want to eat much or bathe). Anyway, we then had a very short time to find another place as they couldn't keep him at the hospital longer as had already started discharge process for the one SNF. Yikes.
Anyway, did find another that is really nice (Bill not happy he has to share a bath - he didn't see the other places we had checked out and turned down - even 5 star places. A very long drive and of course I have no transportation while Robin is at school. And by the time she gets home she is exhausted and already had to face a drive and traffic.
We got there last night and after five minutes Bill was trying to shoo us out so he could get back to his game. Then his dinner came and he wouldn't eat while we were there (hopefully he ate afterwards but he was already claiming he wasn't hungry).
Since he will be involved in a lot of therapy visits are going to be limited. He does have a direct phone line - which means a 3 minute call!

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I'm glad you found a suitable place. I know it's hard not to be at his side, but that might be good too - he'll be busy with therapy, and hopefully they will also get him out with others - at least for a meal or two, so he can see he's not alone in his "woes".
Sue

REPLY
Julie Chitwood | @billchitwood | Sep 19, 2022

Bill was admitted to a skilled nursing home for therapy yesterday. One place wouldn't take him. Our choice said yes and then declined him (worried about his behavioral problems even after being assured by Mayo that they were under control with his medicines and he had been no problem (other then he didn't want to eat much or bathe). Anyway, we then had a very short time to find another place as they couldn't keep him at the hospital longer as had already started discharge process for the one SNF. Yikes.
Anyway, did find another that is really nice (Bill not happy he has to share a bath - he didn't see the other places we had checked out and turned down - even 5 star places. A very long drive and of course I have no transportation while Robin is at school. And by the time she gets home she is exhausted and already had to face a drive and traffic.
We got there last night and after five minutes Bill was trying to shoo us out so he could get back to his game. Then his dinner came and he wouldn't eat while we were there (hopefully he ate afterwards but he was already claiming he wasn't hungry).
Since he will be involved in a lot of therapy visits are going to be limited. He does have a direct phone line - which means a 3 minute call!

REPLY
1 reply
Julie Chitwood | @billchitwood | Sep 18, 2022
In reply to @sueinmn "Are the GFR ratings better because he is hydrated? Just a thought. Hug! Sue" + (show)
@sueinmn

Are the GFR ratings better because he is hydrated?
Just a thought.
Hug!
Sue

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I'm not sure. He has always had a lot of water - even at night has bottle of water next to him.

Would being hydrated cure years of Stage 3 CKD?

Will it drop as soon as they stop hydrating him and he leaves the hospital?

I've access to all his reports/tests, etc. but reading 'doctorize' can be difficult. At least for me. No moment seems they are concerned about something and then nothing more shows up. So I assume it turned out not to be a concern.

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Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 18, 2022
In reply to @billchitwood "He is refusing most food, other than fruit, at the hospital. And refusing to bathe. I..." + (show)
@billchitwood

He is refusing most food, other than fruit, at the hospital. And refusing to bathe. I have an uneasy feeling he is going to get kicked out of rehab fairly quickly as he has a history of refusing rehab.

The strangest thing is his GRF ratings???

He also has some slight heart issues.

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Are the GFR ratings better because he is hydrated?
Just a thought.
Hug!
Sue

REPLY
1 reply
Julie Chitwood | @billchitwood | Sep 18, 2022
In reply to @sueinmn "I am glad you are getting him the help he needs. But he is not going..." + (show)
@sueinmn

I am glad you are getting him the help he needs. But he is not going to be happy in rehab, is he? Operating on a therapy schedule is tough business - they will have him moving, and only serve him the foods on his CKD diet!
I wish you and Robin strength and patience these next days.
Sue

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He is refusing most food, other than fruit, at the hospital. And refusing to bathe. I have an uneasy feeling he is going to get kicked out of rehab fairly quickly as he has a history of refusing rehab.

The strangest thing is his GRF ratings???

He also has some slight heart issues.

REPLY
1 reply
Julie Chitwood | @billchitwood | Sep 18, 2022
In reply to @billchitwood "Bill ended up in hospital rather then his doctor appointment when his BP showed 78/38 and..." + (show)
@billchitwood

Bill ended up in hospital rather then his doctor appointment when his BP showed 78/38 and heart beat at 58.
They put him on fluid IV. First blood test showed GFR at 42 (slightly lower than it has been). Then each test after that had his GFR going higher and higher and yesterday it was at 62! Seems so weird after two and a half years on being on the cusp of Stage 3 a/b.

They are changing his meds - cutting some out like his BP med! Could meds have caused his low GFR readings?

He is being released to a skilled nursing home for two weeks of therapy. Maybe today if they can find a place that will take him. He has behavior issues. Mild dementia.

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This morning's test shows his GRF now at 67.
Showing anemic, which figures have basically stayed the same.

REPLY
Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 18, 2022
In reply to @billchitwood "Bill ended up in hospital rather then his doctor appointment when his BP showed 78/38 and..." + (show)
@billchitwood

Bill ended up in hospital rather then his doctor appointment when his BP showed 78/38 and heart beat at 58.
They put him on fluid IV. First blood test showed GFR at 42 (slightly lower than it has been). Then each test after that had his GFR going higher and higher and yesterday it was at 62! Seems so weird after two and a half years on being on the cusp of Stage 3 a/b.

They are changing his meds - cutting some out like his BP med! Could meds have caused his low GFR readings?

He is being released to a skilled nursing home for two weeks of therapy. Maybe today if they can find a place that will take him. He has behavior issues. Mild dementia.

Jump to this post

I am glad you are getting him the help he needs. But he is not going to be happy in rehab, is he? Operating on a therapy schedule is tough business - they will have him moving, and only serve him the foods on his CKD diet!
I wish you and Robin strength and patience these next days.
Sue

REPLY
1 reply
Julie Chitwood | @billchitwood | Sep 18, 2022

Bill ended up in hospital rather then his doctor appointment when his BP showed 78/38 and heart beat at 58.
They put him on fluid IV. First blood test showed GFR at 42 (slightly lower than it has been). Then each test after that had his GFR going higher and higher and yesterday it was at 62! Seems so weird after two and a half years on being on the cusp of Stage 3 a/b.

They are changing his meds - cutting some out like his BP med! Could meds have caused his low GFR readings?

He is being released to a skilled nursing home for two weeks of therapy. Maybe today if they can find a place that will take him. He has behavior issues. Mild dementia.

REPLY
2 replies
Mentor
Rosemary, Volunteer Mentor | @rosemarya | Sep 15, 2022
In reply to @billchitwood "Yesterday we went to Mayo for two appointments, afternoon one to be 4 hour testing on..." + (show)
@billchitwood

Yesterday we went to Mayo for two appointments, afternoon one to be 4 hour testing on the dementia. Checked in for first appointment and panic ensued as his vitals were 78/38 Heart rate 53. Room quickly filled up with emergency people - then off to Mayo ER. Robin arrived, leaving her 6th grade class doing a non stress math test. Lots of tests run - they still have him and running more tests. Not sure if he gets sprung today or not (no transportation until late afternoon). Robin and I finally got home about 7pm so a very long day as started for Mayo at 8:15am Ubering.
What is odd on notes it was mentioned ​ HTN with CKD stage 4 - among other problems he has. His GFR has consistently shown Stage 3 a or b (goes up and down from a/b). They did confirm yesterday he is anemic, which I had guessed from previous blood tests.
Does anyone know what HTN with CKD means? And is that why they are showing Stage 4?
Haven't been able to talk to him as his phone is goofed up. Since he can no longer use phones without my help I'm not sure if he goofed it up or it is just goofed up!
So now need to reschedule another whole day at Mayo! At least their food is good - although we didn't get to eat yesterday as in ER - and it was packed. Tried for steak and lobster but they said they had just given the last one away lol.
So waiting for doctor's report.
I did get to ride in the front seat of the ambulance. A first and hope not to be repeated. That ER room was freezing. They did bring in blankets for the three of us but still cold. It felt so good to walk out into Phoenix heat!

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Julie, I take meds for high blood pressure. And my blood pressure is controlled with the prescribed medications. So - all of my health records list me with HTN, even though it is controlled with meds.

REPLY
Julie Chitwood | @billchitwood | Sep 15, 2022
In reply to @sueinmn "I hope you get some answers soon - waiting is so hard. Hugs! Sue" + (show)
@sueinmn

I hope you get some answers soon - waiting is so hard.
Hugs!
Sue

Jump to this post

Trying to read 'doctor speak' is challenging. I'm guessing if a test shows 'moderate' - like in calcium build-up that means it isn't a good thing but not dangerous.

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