Re: Re: Secondary Aldosteronism

[Guest guest]

I do have some kidney loss. It comes and goes. My GFR ranges from

59 to >60.

My creatinine ranges from 0.7-1.3

Either way I am 99% sure I have nailed down my problem after all

these years cause DASH and the two pills have

did wonders.

Phyllis

Dr grim needs to correct this if it wrong. I would say if

you had Secondary Aldosteronism for 15 years you would

have some loss of kidney function.

> > >

> > > I wonder if I have secondary? I was on

Benicar 10mg and Inspra 50mg

> > daily with good bp. I weaned off the Benicar and

my bp is slowly going up.

> > >

> > > I read this article:

> > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > >

> > >

> > > It said "Secondary hyperaldosteronism is

the result of the

> > hypersecretion of aldosterone as a consequence

of increased activation

> > of the renin-angiotensin system (RAS)."

> > >

> > >

> > >

> > > Phyllis

> > >

> > > meds: Inspra 50mg

> > > dx: LVH, cardiomyapthy, Insulin Resistance,

GERD, possible PA?

> > >

> >

> >

>

[Guest guest]

Depends on the cause of the secondary aldo.

Most common cause would be renal artery stenosis and

may or may not have impaired renal function.

I have an MRI that ruled out renal artery

stenosis.

The comment that she has no insurance and cant afford

to be tested but can affore to take up to 6 BP pills.

I had insurance and they were 4.00 Walmart

drugs.

Bad economics I would think.

You darn skippy bad economics. You see I have

not always been uninsured. How

ironic for the past 15 years when I had the best of the best

insurance

and still couldn't get diagnosed. I went to doctor after doctor

with that good insurance. They piled on pill after pill all the

while my heart, kidneys and brain was taking

a beating. They said I was noncompliant, fat, stressed, etc...

this was the problem.

Maybe if I was smart enough I would have asked them to test me for

renin, aldo, etc...

Fast forward to today, after my job went over seas and Cobra was

650.00 per month. I am now uninsured.

LAb companies only give you discounts if they have agreements with

the insurance companies. Otherwise they charge you full price.

And if you have an outstanding bill with them- well you can forget

about getting service from them.

SO my delimena is to not take the 150.00 Inspra prescription or

save up two months and get tested.

My guess is a renin and aldo and 24 hr urine cost

about $250 or less and would have saved many years of

the wrong meds.

The problem with this statement is that in the

United States you have to have an order from a Physicain to get

lab work done.

ANd since none of the dozen or so doctors over the 15 years

ordered them......

But dont know the details.

Maybe someone can look up the cost of a plasma renin,

aldosterone, 24 hr urine for aldosterone, sodium and

potassium and creatinine.

Thanks

CE Grim

On Oct 22, 2011, at 10:25 AM, Francis Bill

SUSPECTED PA wrote:

Dr grim needs to correct this if it wrong. I

would say if you had Secondary Aldosteronism

for 15 years you would have some loss of

kidney function.

> > >

> > > I wonder if I have secondary? I

was on Benicar 10mg and Inspra 50mg

> > daily with good bp. I weaned off the

Benicar and my bp is slowly going up.

> > >

> > > I read this article:

> > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > >

> > >

> > > It said "Secondary

hyperaldosteronism is the result of the

> > hypersecretion of aldosterone as a

consequence of increased activation

> > of the renin-angiotensin system

(RAS)."

> > >

> > >

> > >

> > > Phyllis

> > >

> > > meds: Inspra 50mg

> > > dx: LVH, cardiomyapthy, Insulin

Resistance, GERD, possible PA?

> > >

> >

> >

>

[Guest guest]

Think I have your FH mixed up with someone else. Is your son a teacher? Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Brother had Polycystic Kidney Disease and a transplant ~1994. New kidneys were starting to fail 13 yrs later (2007) when he ended up in ER w/ruptured colon. Kidneys weren't strong enough to recover. Don't know his K status although his daughter, who is a nurse and also has PKD, Or his exwife, a NP, probably know. Mother had HTN and only one kidney. (Had other removed at age 26 because it was nonfunctioning.)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > >

> > > > > > I wonder if I have secondary? I was on Benicar 10mg and

> > Inspra 50mg

> > > > > daily with good bp. I weaned off the Benicar and my bp is

> > slowly going up.

> > > > > >

> > > > > > I read this article:

> > > > > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > > > > >

> > > > > >

> > > > > > It said "Secondary hyperaldosteronism is the result of the

> > > > > hypersecretion of aldosterone as a consequence of increased

> > activation

> > > > > of the renin-angiotensin system (RAS)."

> > > > > >

> > > > > >

> > > > > >

> > > > > > Phyllis

> > > > > >

> > > > > > meds: Inspra 50mg

> > > > > > dx: LVH, cardiomyapthy, Insulin Resistance, GERD, possible PA?

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Jgcell tumor is so rare I have never seen one and secondary Aldo is usually profound. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

It has not been determined If she even has PA. She only knows that sprio lowered her B/P. She was asking about possable secondary aldosteronism.

One cause of Secondary Aldosteronism is a juxtaglomerular cell tumor. Another is renal artery stenosis. Belive both over time would cause some loss of kidney function.

If she does have Secondary Aldosteronism after 15 years seem it would would have loss of kidney function. If not then she most likey doesn't have Secondary Aldosteronism.

I would hope she has the labs that would show what her kidney function is.

> > > > >

> > > > > I wonder if I have secondary? I was on Benicar 10mg and Inspra 50mg

> > > > daily with good bp. I weaned off the Benicar and my bp is slowly going up.

> > > > >

> > > > > I read this article:

> > > > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > > > >

> > > > >

> > > > > It said "Secondary hyperaldosteronism is the result of the

> > > > hypersecretion of aldosterone as a consequence of increased activation

> > > > of the renin-angiotensin system (RAS)."

> > > > >

> > > > >

> > > > >

> > > > > Phyllis

> > > > >

> > > > > meds: Inspra 50mg

> > > > > dx: LVH, cardiomyapthy, Insulin Resistance, GERD, possible PA?

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

Trust your Phoenix will be serving the DASH diet as many have BP problems.You might even want to teach how to take your own BP. We have a bunch of VHS tapes we can sell cheap on how to do this.CE Grim MD No, I think you are right. Oldest son,w/HBP, is a Principal in a H.S. Second son, with probable HBP, is in top level hotel management currently in Orlando, FL. (He works for a large hotel group and is currently their top nationwide troubleshooter waiting for his own property.) Daughter is an OT, w/HBP, and has been in treatment since college days. I'm in the process of developing a packet for each of them and their doctors. (Dr. Grim's evolution, and testing proceedure and the address of this group.) I'm currently working on the political aspects of bring a "Phoenix House" D. and A. rehab. house to Barre and then my efforts on to them. (Thanksgiving time) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > > > > > > > > I wonder if I have secondary? I was on Benicar 10mg and > > > > Inspra 50mg > > > > > > > daily with good bp. I weaned off the Benicar and my bp is > > > > slowly going up. > > > > > > > > > > > > > > > > I read this article: > > > > > > > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm > > > > > > > > > > > > > > > > > > > > > > > > It said "Secondary hyperaldosteronism is the result of the > > > > > > > hypersecretion of aldosterone as a consequence of increased > > > > activation > > > > > > > of the renin-angiotensin system (RAS)." > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Phyllis > > > > > > > > > > > > > > > > meds: Inspra 50mg > > > > > > > > dx: LVH, cardiomyapthy, Insulin Resistance, GERD, possible PA? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Good time to DASH like your life and pocketbook depended on it Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Depends on the cause of the secondary aldo.

Most common cause would be renal artery stenosis and

may or may not have impaired renal function.

I have an MRI that ruled out renal artery

stenosis.

The comment that she has no insurance and cant afford

to be tested but can affore to take up to 6 BP pills.

I had insurance and they were 4.00 Walmart

drugs.

Bad economics I would think.

You darn skippy bad economics. You see I have

not always been uninsured. How

ironic for the past 15 years when I had the best of the best

insurance

and still couldn't get diagnosed. I went to doctor after doctor

with that good insurance. They piled on pill after pill all the

while my heart, kidneys and brain was taking

a beating. They said I was noncompliant, fat, stressed, etc...

this was the problem.

Maybe if I was smart enough I would have asked them to test me for

renin, aldo, etc...

Fast forward to today, after my job went over seas and Cobra was

650.00 per month. I am now uninsured.

LAb companies only give you discounts if they have agreements with

the insurance companies. Otherwise they charge you full price.

And if you have an outstanding bill with them- well you can forget

about getting service from them.

SO my delimena is to not take the 150.00 Inspra prescription or

save up two months and get tested.

My guess is a renin and aldo and 24 hr urine cost

about $250 or less and would have saved many years of

the wrong meds.

The problem with this statement is that in the

United States you have to have an order from a Physicain to get

lab work done.

ANd since none of the dozen or so doctors over the 15 years

ordered them......

But dont know the details.

Maybe someone can look up the cost of a plasma renin,

aldosterone, 24 hr urine for aldosterone, sodium and

potassium and creatinine.

Thanks

CE Grim

On Oct 22, 2011, at 10:25 AM, Francis Bill

SUSPECTED PA wrote:

Dr grim needs to correct this if it wrong. I

would say if you had Secondary Aldosteronism

for 15 years you would have some loss of

kidney function.

> > >

> > > I wonder if I have secondary? I

was on Benicar 10mg and Inspra 50mg

> > daily with good bp. I weaned off the

Benicar and my bp is slowly going up.

> > >

> > > I read this article:

> > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > >

> > >

> > > It said "Secondary

hyperaldosteronism is the result of the

> > hypersecretion of aldosterone as a

consequence of increased activation

> > of the renin-angiotensin system

(RAS)."

> > >

> > >

> > >

> > > Phyllis

> > >

> > > meds: Inspra 50mg

> > > dx: LVH, cardiomyapthy, Insulin

Resistance, GERD, possible PA?

> > >

> >

> >

>

[Guest guest]

MRIs do not rule out RAS. The only way to do that is with a classic transfemoral renal arteriogram with selective renal artery studies.Been there and done that and can assure you that MRI is only a screening test. CE Grim MD Depends on the cause of the secondary aldo. Most common cause would be renal artery stenosis and may or may not have impaired renal function. I have an MRI that ruled out renal artery stenosis. The comment that she has no insurance and cant afford to be tested but can affore to take up to 6 BP pills. I had insurance and they were 4.00 Walmart drugs. Bad economics I would think. You darn skippy bad economics. You see I have not always been uninsured. How ironic for the past 15 years when I had the best of the best insurance and still couldn't get diagnosed. I went to doctor after doctor with that good insurance. They piled on pill after pill all the while my heart, kidneys and brain was taking a beating. They said I was noncompliant, fat, stressed, etc... this was the problem. Maybe if I was smart enough I would have asked them to test me for renin, aldo, etc... Fast forward to today, after my job went over seas and Cobra was 650.00 per month. I am now uninsured. LAb companies only give you discounts if they have agreements with the insurance companies. Otherwise they charge you full price. And if you have an outstanding bill with them- well you can forget about getting service from them. SO my delimena is to not take the 150.00 Inspra prescription or save up two months and get tested. My guess is a renin and aldo and 24 hr urine cost about $250 or less and would have saved many years of the wrong meds. The problem with this statement is that in the United States you have to have an order from a Physicain to get lab work done. ANd since none of the dozen or so doctors over the 15 years ordered them...... But dont know the details. Maybe someone can look up the cost of a plasma renin, aldosterone, 24 hr urine for aldosterone, sodium and potassium and creatinine. Thanks CE Grim On Oct 22, 2011, at 10:25 AM, Francis Bill SUSPECTED PA wrote: Dr grim needs to correct this if it wrong. I would say if you had Secondary Aldosteronism for 15 years you would have some loss of kidney function. > > > > > > I wonder if I have secondary? I was on Benicar 10mg and Inspra 50mg > > daily with good bp. I weaned off the Benicar and my bp is slowly going up. > > > > > > I read this article: > > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm > > > > > > > > > It said "Secondary hyperaldosteronism is the result of the > > hypersecretion of aldosterone as a consequence of increased activation > > of the renin-angiotensin system (RAS)." > > > > > > > > > > > > Phyllis > > > > > > meds: Inspra 50mg > > > dx: LVH, cardiomyapthy, Insulin Resistance, GERD, possible PA? > > > > > > > >

[Guest guest]

Excess also and salt is a classic way to cause heart vessel and kidney fubrosisMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I do have some kidney loss. It comes and goes. My GFR ranges from

59 to >60.

My creatinine ranges from 0.7-1.3

Either way I am 99% sure I have nailed down my problem after all

these years cause DASH and the two pills have

did wonders.

Phyllis

Dr grim needs to correct this if it wrong. I would say if

you had Secondary Aldosteronism for 15 years you would

have some loss of kidney function.

> > >

> > > I wonder if I have secondary? I was on

Benicar 10mg and Inspra 50mg

> > daily with good bp. I weaned off the Benicar and

my bp is slowly going up.

> > >

> > > I read this article:

> > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > >

> > >

> > > It said "Secondary hyperaldosteronism is

the result of the

> > hypersecretion of aldosterone as a consequence

of increased activation

> > of the renin-angiotensin system (RAS)."

> > >

> > >

> > >

> > > Phyllis

> > >

> > > meds: Inspra 50mg

> > > dx: LVH, cardiomyapthy, Insulin Resistance,

GERD, possible PA?

> > >

> >

> >

>

[Guest guest]

Independent of BP high salt diet can also damage kidneys. See studies by McGregor et al on salt intake and proteinuriA which indicates kidney damage May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Phyllis, If I remember correctly you are around my age. eGFR declines as you age and becomes less reliable in ages over 60. Normal creatinine for females is 0.5 - 1.1 so you report some slightly high, I would review external reasons it can be elevated before I got too alarmed.

And if you are happy with your DX and you feel good you are right, you've nailed down your problem, good for you! BYW kidney issues can be helped by getting HTN under control. I may know more about this after appt./Neprologist tomorrow.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > >

> > > > > I wonder if I have secondary? I was on Benicar 10mg and Inspra 50mg

> > > > daily with good bp. I weaned off the Benicar and my bp is slowly

> > going up.

> > > > >

> > > > > I read this article:

> > > > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > > > >

> > > > >

> > > > > It said "Secondary hyperaldosteronism is the result of the

> > > > hypersecretion of aldosterone as a consequence of increased

> > activation

> > > > of the renin-angiotensin system (RAS)."

> > > > >

> > > > >

> > > > >

> > > > > Phyllis

> > > > >

> > > > > meds: Inspra 50mg

> > > > > dx: LVH, cardiomyapthy, Insulin Resistance, GERD, possible PA?

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Best to keep plot of 1/PCr x axis and time on x axis to follow pattern. Could also do eGFR on Y over time. As far back as u can find. Or u can do ehfrMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Phyllis, If I remember correctly you are around my age. eGFR declines as you age and becomes less reliable in ages over 60. Normal creatinine for females is 0.5 - 1.1 so you report some slightly high, I would review external reasons it can be elevated before I got too alarmed.

And if you are happy with your DX and you feel good you are right, you've nailed down your problem, good for you! BYW kidney issues can be helped by getting HTN under control. I may know more about this after appt./Neprologist tomorrow.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > >

> > > > > I wonder if I have secondary? I was on Benicar 10mg and Inspra 50mg

> > > > daily with good bp. I weaned off the Benicar and my bp is slowly

> > going up.

> > > > >

> > > > > I read this article:

> > > > http://www.endotext.org/adrenal/adrenal23/adrenal23.htm

> > > > >

> > > > >

> > > > > It said "Secondary hyperaldosteronism is the result of the

> > > > hypersecretion of aldosterone as a consequence of increased

> > activation

> > > > of the renin-angiotensin system (RAS)."

> > > > >

> > > > >

> > > > >

> > > > > Phyllis

> > > > >

> > > > > meds: Inspra 50mg

> > > > > dx: LVH, cardiomyapthy, Insulin Resistance, GERD, possible PA?

> > > > >

> > > >

> > > >

> > >

> >

> >

>