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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Medical
Satisfied Customers: 2720
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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I have stage three kidney disease with one kidney. I also

Customer Question

I have stage three kidney disease with one kidney. I also have chronic hypertension I take 100mg. of hydralazine twice a day with verapamil 240 mg but my blood pressure is still 150/90 what should I do?
JA: When was last time you had a check up? Is there a history of high blood pressure in your family?
Customer: I had a check up yesterday and yes my mother was hypertensive
JA: Anything else in your medical history you think the doctor should know?
Customer: He knows my medical history he referred me to a nephrologist
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Doctor about your situation and then connect you two.
Submitted: 4 months ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 4 months ago.


Im sorry to hear about your high blood pressure.

Well there are other options for your blood pressure to be controlled. Verapamil is not a very good drug to control the blood pressure, it is primarily used to control abnormal heart rhythms. This is why when calcium channel blockers are advised in patients with renal failure another form is used, like nifedipine and amlodipine. These are better drugs to control the high blood pressure. Now if they cant be used, then your doctor can add another drug to the regimen such as an alpha blocker like prazosin etc.

Lastly if your creatinine levels are under 3 and you dont have problems with retention of potassium in the body and are also producing adequate amounts of urine, then ACE inhibitors like lisinopril or better yet Angiotensin receptor blockers can be used which are also renoprotective. These would include drugs like candesartan or valasartan. These are excellent in controlling blood pressure.

Now if your blood pressure is elevated right now AND you are having symptoms like headaches, sweating, shortnes of breathm , dizziness, lightheadedness, palpitations etc then unfortunately you will have to go to the ER. if not simply call up your doctor and ask him about the above options. Im sure he can adjust your prescription over the phone if needed.

I think using any of the options above would be beneficial in controlling your blood pressure. Dietary modifications are also necessary, if you are not already controlling your intake of salt etc that is. lastly if none of the above work, then direct renin blockers can be used in very resistant hypertension however i think you wont need those drugs just yet. Talk to your nephrologist about these above options.

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