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CamilleRN
CamilleRN, Nurse (RN)
Category: Health
Satisfied Customers: 4183
Experience:  Experience: 20 yrs experience in ER, ICU, Neuro, OR, Chemo,Cardiology, Dermatology and MORE.
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very good health before blood clot damaged his kidneys..his chest..arm

Customer Question

My husband has been on hemodialysis for 23 months,
(was in very good health before blood clot damaged his kidneys)
-is continuing to use the temporary port placed in his chest,due to 2 failed attempts to place fistulas first in L lower,then upper arm.
-he was found to have clotting problem,and takes Coumadin daily and tests his levels at home regularly.
My question:
His BP is erratically high despite currently taking5 different BP meds,especially after dialysis-- 190/110 noy unusual.
No one is giving us answers--seems to be "nothing to worry about".
Meanwhile, his BP med makes him too sleepy to do anything,much less function at his full time job, and he is "seeing things" (spiders crawling on bed,men in the house at night).
Does he need stress test?
Could it be due to the failed fistula attempts?
Other?
(He is 62 yrs old, and was so vigorous til kidney damage)
Submitted: 6 years ago.
Category: Health
Expert:  CamilleRN replied 6 years ago.
Welcome to JustAnswer Health...and thank you for your question. I am a verified Expert and am delighted to help you today. When Kidneys are damaged it can be very difficult to regulate the blood pressure... keep track of it and let the Doctor know when it spikes.. he will continue to add and delete meds until the right combination can be found, sometimes this can take quite some time. The delusions need to be addressed by his Doctor who needs to figure out the cause as well as treatment... is he having any liver problems?Liver problems can cause his ammonia level to rise which can cause delusions and hallucinations.
Customer: replied 6 years ago.

no liver problems--he does not drink alcohol,his blood work is good, except for low protein and slightly elevated phosphorus, and slight anemia which is treated at clinic with erthyropoetin and iron.

 

please name some meds that are used successfully, to replace the clonidine (patches itch terribly, makes him sleepy), Norvasc makes him swell, and Toprol-delusions started when that was initiated.

 

what type of MD should we consult? nephrologist,cardiologist,hypertension specialist?

 

please explain why BP is so difficult to regulate--what are the possible causes?

 

is it possible the failed AV fistulas are having some effect?

should he be tested for narrowing of vessels?

should we seek help from the transplant center in our state?

what are best available sources for info?

could he be reacting to fluid or tubing?

 

Customer: replied 6 years ago.
I replied on 6/1/10 at 12:15pm--would you please address the possibility of narrowing vessels in the kidneys,or the possibility of maybe a tumor in adrenals, or other such various causes of difficulty controlling BP with kidney failure.
Customer: replied 6 years ago.
Relist: Incomplete answer.
what are causes of such difficulty stabilizing BP of dialysis pt, and what tests can be run to identify problem?
What new medications are being used for such problems?