Blood Pressure Medication Recalled! What is the Next Step?

Losartan and other antihypertensive medications have recently been recalled. As a specialist in the treatment of high blood pressure and diabetic kidney disease, I am one of the many providers receiving phone calls from patients who are taking this therapy. People have concerns. They have questions regarding the next steps. Should they get off the medication (were they affected by the recall)? What is the best way to proceed?

Figure: The 10 most written prescription drugs in the United States (2016 Data):

How Severe Is My Chronic Kidney Disease?

Nephrologists use formulas to determine whether or not you have chronic kidney disease (CKD). The following pieces of information are plugged into a formula to determine your stage:

1. How old you are
2  Whether you are male or female
3. Your race (black or white)
4. Your gender (female or male)
5. The result of certain blood tests, usually the creatinine.

If the number turns out to be less than 60 for 3 months or more, you are likely to have chronic kidney disease or CKD.

White coat hypertension: the Importance of Correlating the Cuff

As a high blood pressure specialist, I get referrals to help patients get to their target blood pressure goals. Sometimes there is a discrepancy between the blood pressure recorded in the nephrologist's office and the patient's blood pressure at home. I commonly hear from the patients I serve the following: "I have white coat hypertension Doctor Aaronson. My blood pressure is high in the office, but it is normal at home. I just get nervous in the office and my pressure increases." And many times this statement made by the patient is spot-on correct. The prevalence of white coat hypertension is common in the population and ranges from 13 to 35 percent.

Having High Potassium in the Human Body: the Meaning of Hyperkalemia and Some Whys

Sometimes patients are referred to the kidney doctor for high or low potassium levels. Today we are going to discuss the meaning of elevated potassium levels in the body. First, we will discuss numbers to get everyone on the same page. These are the ones you see on the printout the doctor's office gives you, in the electronic medical record, and the ones the nurse or medical assistant calls you with:

• Normal potassium or normokalemia is defined as 3.5-5.0 milliEquivalents per liter (mEq/L).
• Mildly elevated potassium or hyperkalemia is defined as 5.1 to 6.
• Moderately elevated hyperkalemia is greater than 6.
• And severely high potassium is above 7 milliequivalent per liter.

The Kidney Biopsy in a Nutshell

Figure: kidney biopsy demonstrating a condition called focal segmental glomerulosclerosis (abbreviated fsgs) in a patient who was spilling grams of protein in her urine. The picture shows a glomerulus, or filter, of the kidney. There is scarring of the filter at 3 o'clock.

Your nephrologist may tell you that you need to have a kidney biopsy to help figure out why your kidneys are failing. The purpose of the procedure is to diagnose the cause of the kidney disease and determine the appropriate treatment.

Some examples of people who might need a biopsy of their kidneys include: