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Kidney Diseases

24 Year Old - High BP & Leaking Kidney

04/30/2009

Question:

I am 24. I have noticed and have been monitoring my blood pressure for the past 5 months and it is "high". Having been to the doctors, eventually I had a blood test and have received the results.

As stated by the GP I have protein leaking from my kidney. also I have white blood cells in my urine, yet no trace of an infection. Everything else in my blood was of a good standard.

My GP has prescribed me with ramipril as a high blood pressure tablet and has asked me to have another blood test and follow up appointment in 6 weeks.

In response to this my mother has found a more competent doctor whom I am visiting tomorrow in London, so hopefully no stone will be left unturned.

Just inquiring whether you have any thoughts as to what is happening or why. If you could offer any information it would be appreciated. Because of my age this is of a concern.

Regards.

Answer:

Your GP took the correct first step, as ramipril is a good choice for hypertension in patients with proteinuria. Now the important questions are:

1) Why do you have proteinuria and what is the quantity? If the proteinuria is uniquely a result of your BP elevation then it should resolve with good BP control. If the proteinuria is a marker of underlying kidney disease then you will need further blood and urine testing and maybe even a kidney biopsy.

2) You and your doctor must determine a "goal" for your BP. To achieve this goal may require more than one BP medication. Without knowing anything else about your condition the initial systolic BP goal should be about 125 mmHg, but this may be adjusted up or down depending on your specific circumstance.

3) You stated that the blood tests were of good standard. Specifically you will want to know the serum creatinine and with that information you can determine what "stage" of kidney disease you have (there are 5 stages of kidney disease).

After you have had these questions answered by the consultant, you are welcome to write back for further input.

For more information:

Go to the Kidney Diseases health topic, where you can:

Response by:

Thomas Zipp, MD Thomas Zipp, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University