Renal function and K

[Guest guest]

Dear all,I changed the subject line because it worries me very much now. Dianne, I am very interested in how high K influences a kidney function. My last Basic Metabolic showed that my EGFR dropped from 50 in 6 months ago to 43 and my Urea Nitrogen is now 34 (normal 7 -25), creatinine is 1.29 ( normal 0.5 - 0.99), Bun/creatinine ratio is 26.1 ( 6 -22), and my K is 5.1. I will put everything in Excel worksheet and send it to the group and Dr. Grim in a couple of days. In meantime I have an appointment with my endo tomorrow and would like to be prepared a little. What can I do to improve EGFR or at least not

to make it worse and worse? Drink more? Drink less? Drink and eat what? What is your EGFR, Dianne? When it becomes dangerously low, with which number? What to do then? Dialyzes? My nephrologist said 43 is satisfactory. Is it definitely? How do you control your consumption of K? What do you usually eat every day? What should we avoid? You said once that you increase K when you start to have cramps, did you? I swim now about 1 hour every day in a pretty cold water (around 73 degrees) and don't have any cramps. Does it mean that I have to consume less tomatoes and celery? I definitely don't know how to regulate it on a day to day basis.And my renal function scares me a lot, since I don't see why it's getting so much worse. My average BP is 110- 120/ 70- 75. I didn't get any Cat scan during

last 10 months. BTW, all doctors recommended to repeat it again in 6 months, but I don't do it. Is it right decision or not? Recently I accidentally overdosed metformin for about 2 -3 weeks. Could it effect EGFR so significantly? Or it might be due to my diabetes getting worse?Thank all of you for your thoughts and opinions, Natalia Kamneva 68 Russian F with 2.5 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 75 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.

From: Dianne strong <dianstrong@...> hyperaldosteronism Sent: Monday, June 25, 2012 9:03 AM Subject: Re: Saline suppression scheduled

Phyllis, I could almost have written much of your story myself. My BP was 224/114 and all the BP clinic at Kaiser would do is double-down on my meds, some of which caused my K to tank further. My NP would tell me to "lose 10 pounds" and "relax", and I was spending a fortune on BP pills and Kaiser visits. My medical chart had me listed as a "non-compliant" patient, because I refused medications for borderline "diabetes" and borderline high cholesterol, which was 2 points over there recommendation for diabetics. Why I didn't have a stroke is a mystery to me.I had to diagnose myself, via the Internet. When I demanded the urine aldosterone test my NP actually screamed at me over the phone that I "was a non-compliant patient and now I wanted a test for what?" I didn't know then that I really needed an ARR test, but

my

Aldosterone test came back with a reading of 300.1 (0 -29 being normal).To me the really sad thing in your letter is that in the article you read, Dr. Saunders was listed as a "revolutionary" doctor. Not to take anything away from him, but his approach to treating HBP should be common to all doctors and not revolutionary at all., hang in there. As you can see you have people in this group who have been in your position. You are young and may have caught your illness early enough to escape some of the damages that can occur with long term, undiagnosed, PA.

Dianne 69, bi-lateral adenomas 1.2cm rt, 1cm left 25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with

ever increasing BP Diagnosed myself via Internet July 2010 Had to demand tests to confirm PA, from

scoffing NP CKD. Kidney function fell after use of

contrast dye during CT scan 8/2010. Now on 50mg Spiro, 12.5mg Atenolol BP avg. 130/70 Dashing with very low Na (aim for 1,000mg)

and high enough K to keep me in range, but not so high as to further damage

kidneys.

Very anxious about my saline suppression on

Wednesday!

After CT scans. MRI's. Lots of blood

tests.... I am confident this is the end of

my PA journey. Phew! After saline

suppression confirms PA he will put me on

Spiro and hopefully I will respond to it.

I am not sure how many patients my

nephrologist has like me b/c he arranged and

called me himself about my suppression test.

Just got back from vacation and my BP was

195/113 the entire trip! I was very bloated

too.

It will be nice to have BP in the "not so

scary" range. Cross fingers.

38

Aldo 30 (?-28) high

Ratio 78.9 (.9-28.9) high

renin. 38 (.25-5.89) low normal

CT Scan normal

saline suppression 6/27/12