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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Diabetes, High Blood Pressure. Increased Creatinine Serum. Prescribed Lasix. Options?

Hello, It s Faheem from Islamabad Pakistan. I need some advise from you regarding my father s Kidney . My Father is 57 years old,diabetic with high blood pressures usually 160/80 170/90. His sugar level is bit controlled but as per Doctors advise his sugar is maintained due to kidney issue. His latest creatinine serum is 4.16 which increased in last 3 months from 1.98. Medicine he is taking are Lipiget, Loprin, Stress tab, Ammryl,Lophos,Hydrolyzine. He was also using Aproval 300mg but doctor discontinue as increase in creatinine. After h doctor advised to take Lasix 40mg (2 times a day) and mini press 1mg (3 times a day) but creatinine goes to 4.16 from 3.07. Now the doctor is advising to go for testing tissues in the kidney , we have stopped using Lasix and Minipress for the time being could you please advise any option.
Mon, 25 Mar 2013
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Internal Medicine Specialist,  's  Response
Hello!
Thanks for being with us.

Diabetes and hypertension if not adequately controlled leads to gradual decrease in kidney functioning over a period of time.

Here in father's case also same factors could be responsible for kidney injury and increase in creatinine level.Drugs like ACE inhibitors and ARBs also decrease kidney function further,hence these should be avoided.

There is no harm in using lasix and minipress in this case.Lasix increases urine output,avoids fluid overload and help in decreasing blood pressure.Minipress is also safe to use in this case to decrease blood pressure.

Following parameters should be monitored while being on these drugs:
1.serum k+,na,
2.serum calcium,po4,
3.serum uric acid.

My suggestion is have strict blood sugar control and blood pressure control to avoid further kidney damage.

Target blood pressure should be 110/70 mm of hg in this patient.

Hence for better monitoring get a nephrologist opinion.

Hope this will help you better.
Wish you good health.




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Have Diabetes, High Blood Pressure. Increased Creatinine Serum. Prescribed Lasix. Options?

Hello! Thanks for being with us. Diabetes and hypertension if not adequately controlled leads to gradual decrease in kidney functioning over a period of time. Here in father s case also same factors could be responsible for kidney injury and increase in creatinine level.Drugs like ACE inhibitors and ARBs also decrease kidney function further,hence these should be avoided. There is no harm in using lasix and minipress in this case.Lasix increases urine output,avoids fluid overload and help in decreasing blood pressure.Minipress is also safe to use in this case to decrease blood pressure. Following parameters should be monitored while being on these drugs: 1.serum k+,na, 2.serum calcium,po4, 3.serum uric acid. My suggestion is have strict blood sugar control and blood pressure control to avoid further kidney damage. Target blood pressure should be 110/70 mm of hg in this patient. Hence for better monitoring get a nephrologist opinion. Hope this will help you better. Wish you good health.