Question: I had malignant hypertension in year 2005 and consequent to it had acute renal failure, wherein the creatanine stabalized at 3.5. However, with time, the cretanine went up and is now 7.0. However, for the last 4 months a strange thing has happened. My BP has become normal and the only BP medication I am taking is ace inhibitor 25 mg. Notably , before that I was taking two medications, Dilzam hydrocholoride 200 mg and atacand 16/12.5 mgs. My query is , Can BP become normal for a person with CKD . If BP becomes normal, can renal recovery regenerate?
Cretanine clearnace is 16 , urine volume is 1.2 litres. HDL is low, but LDL and tri glyceride is ok. Urine routine shows no albumin and blood , though one year back, it was showing 3+ protein and 50 blood. Anamic.
Need expert opinon of nephrologist on this and only such nephrologist , who has experience in renal regeneration with BP normalization need respond, others kindly escuse. I already have enough expert opionons on the subject and searching only for a doctor, who has managed renal regeneration and improved the cretanine of the patient from 7 to a much lower number , considering BP had normalized. I dont need generalized opionons and I am already aware of ESRD and dialysis etc, so kindly do not spent time on further educating me on that.

Thanks Dr XXXXXXX and your positive response on possible renal regeneration. That is the kind of Doctor, exactly, I am searching.

Herein the answers to your queries

1. Lost of weight : I lost 22 kgs , but gradually over 9 months and not all of a sudden.
2. My diet has always been low salt and low protien and vegetarian. In fact, after the BP became normal, I have tried taking extra salts and achar , just to check, if BP goes up and the highest it went up was127/83 from 115/ 77 as usual normal, without any medications

3. Ultasround : I will check the report, it was done 2 years back and was found quite normal. But, if you think, this is another important input that you need, I will get another ultrasound done and post to you sometime in coming week.

Yes, biopsy was done 10 years back to identify the cause of acute renal failure and it was found malignant hypertension and they diagnosed as hypertensive neprhorsolcorosis. The cretanine was constant at 3.5 for 3 years and then went to 4 and 5.5 and finally 7 now.

However, I must state that I have no physical condition what so ever and I am physically fit and normal as another normal human being and only trying to get my cretanine number in a reasonable range ( I do never expect it to become normal ) say of 25 to 30% functionality of the kidneys.

4. Ferritin : 355
Calcium : 7.5
Hemoglobin : 10
uric Acid : 6.5 ( But once in a while, I take zyrolic 100 mg)
Phosphorus : Not checked

Looking forward to your response.

regards

Awesome !

Thanks for the response and I will do the needful. I do recall that the last USG had shown kidney size as normal and was also confirmed by my neph. But, I will get it examined again.

One last question, The ACE I am taking is 25 mg and is that enough or should I increase it to 50 mg or lower it ?

Lastly and most important. Kindly give your thoughts on the following with your experience with similar such cases.

How much regeneration can I expect ? In terms of serum cretanine number, say from 7, what I can expect to achieve in how much time period ?
Secondly, will it be sustainable long time or progressive.?
With current 10% kidney function, in short, what functionality can I expect in regeneration ?

BP I reckon is already normalized , with or without the ace inhibitor and my diet is always of low salt and low protein.

regards

Thanks Dr XXXXXXX

Your response is reassuring as my neph is quite positive and has predicted the cretanine improvement to 5.5 level, if the BP remains normalized. Let us see, how it goes.

Sometimes while urinating, I have a rectal gas discharge and the urine is interrupted. Do you think, this has to something with ckd or the solution thereof.

Secondly, last two days, my BP has started showing a cyclic effect of normal in morning and then going to 130/85 at around 12 pm and becoming 140/90 by 5 pm and then coming down again to 130/85 around 6 pm and then normal again.
Does it need medication or do you think, this is normal routine spike of BP owing to physical situation and I should not add a medicine to ace.

regards