Dialysis and Blood Pressure

Hey Y’all! Long time. no post. My fault entirely.

Since my transplant in late 2017, I spent my time recovering and absolutely enjoying my new-found life, free of the restraints of dialysis. That doesn’t mean I’m not constantly thinking about you and the world of dialysis. That’s why I want to post about this article, titled “Major Update’ of BP Guidance for Kidney Disease, Treat to 120 mm Hg”

Go ahead and skim over it… I’ll wait…

So, first point, it is meant for CKD patients who are not on dialysis and that might make it seem irrelevant to a dialysis patient. However, the reason I want you aware of this change in BP guidelines is so you understand the importance of blood pressure and its relationship to kidney disease. This decision supports the position that lower BP in kidney patients is extremely important. Keep this in mind every time your blood pressure is measured. Pay attention to the numbers. Watch for the Systolic (top) number and how high it might be above 120, if it is.

BTW, the way I remember which number is which: Like a fraction, where the bottom number is the “denominator”, the bottom number is a blood pressure measure is “diastolic”. They both begin with “D”? Therefore the upper number is “systolic”. Yes, it’s crazy. Yes, it is bordering on silly. But, it works and helps me translate from medical terminology to something I understand. I told one friend about my method and the response was, “I really don’t remember anything about math or fractions!” I guess they’ll have to find something else to help them. I am plumb out of ideas. Needless to say, “Systolic = top number” and “Diastolic – bottom number”

The fundamental reason I bring up this article is to encourage you to advocate for yourself when your blood pressure is being taken. The discussion subtitled, “Take Blood Pressure Well” is essential for dialysis patients, too. For kidney patients, getting a good number is important because it effects your medical treatment for hypertension which is a leading cause of kidney failure and most kidney patients have elevated blood pressure. Taking a poor measure will effect what medications and strengths you are given. Too much or too little can harm your kidney health. Read that section over again with this in mind. Also, keep this in mind when someone puts the blood pressure cuff on you. If you aren’t ready, say so and make sure you are seated for the recommended five minutes before they take a measurement.

The other important point is the new “120” level for systolic pressure. You need to know this because it often takes time for the message to filter down within the professional community. The physician may still be holding onto the 130 level. Likewise the tech or nurse may not be aware of the new number. Like a speed limit, people tend to add a couple miles per hour. Twenty-five becomes thirty or thirty-five. Similarly, 130 becomes 135 or 140. This new number should be held to as closely as possible to avoid the upward “creep” to greater than 120.

As an aside, the lower (diastolic) number used to be 80 and high was considered 90. The new number is 60 with 80 being high.

So, keep a close watch on your BP outside of dialysis. During dialysis, make sure it is being carefully watched and responded to appropriately. Also, keep in mind your BP during dialysis can swing widely (usually downward) which is why it is constantly monitored. Outside dialysis, it is your responsibility to monitor your BP. Measure a couple times a day or more; upon waking, mid-day and evening before bed are usually recommended times. If it is staying above 120/60, speak with your doc about adjustment to your meds. If is ranges above 130/70 or 140/80 in multiple measures, two things, 1) measure more often and 2) seek medical advice.

Keep that BP under control!

Thanks for reading DevonTexas.com and sorry for not writing more often. Stay healthy!

About DevonTexas

I am a person with ESRD (End Stage Renal Disease) which means my kidneys don't work. Forty or so years ago that would have been a death sentence but today there is Dialysis which means I can be hooked up to a machine that will clean my blood as the kidneys should. Three days a week, I go to a center and have too very large needles stuck in my arm to remove and replace my blood as it passes through a process where it's cleaned and the fluid is removed, a process taking a little over four hours each time. I want to advance knowledge about dialysis so that other patients can learn from my experience and mistakes. We shouldn't have to reinvent the wheel, eh? There is so much to be learned and experienced about our predicament. There are vast resources available to support us and enrich our lives but many patients don't know about them. There are also many issues that we have to deal with whether we want to or not. So I blog about them. All comments are confidential until I approve them. If you don't want your comment public, let me know and I will respect that. So, feel free to leave a comment. Enjoy.
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