Hypotension

While I was on dialysis, especially after starting hemodialysis again after heart surgery, my blood pressure has been all over the place. I published many posts with a record of my blood pressure readings during dialysis, and it can range from over 200 to under 100. I usually do not feel anything when the blood pressure is high, but I would feel dizzy and nauseous when it drops below 110, especially when standing. I was taking three different medications for blood pressure, but it was still pretty much out of control.

Post transplant, my blood pressure would still fluctuate wildly, even though the new kidney was doing its job of clearing fluid from my cells and bloodstream. They kept me on 25mg of Metoprolol Tartrate and also 30mg of Nifedipine ER (extended release). Initially, my blood pressure would still reach 190-200, but some of it was due to the prednisone I was taking. As the doctors reduced my anti-rejection medication, I feel my blood pressure was becoming more stable. Earlier this week, I think it stayed within 110 to 160 for the systolic measurement. After Thursday’s clinic, they cut my prescription of Mycophenolate completely, so I am on the minimal dosage of prednisone, and about the same dosage of Tacrolimus as when I was discharged.

Since Thursday, my blood pressure has been pretty stable. I have only been taking the Metoprolol since I am very sensitive to Nifedipine, and I did not want to drop my blood pressure too much and have hypotension. Today at dinner, I measured 159 sitting and about 135 standing so I took the Nifedipine pill; I believe I have skipped it for the past two days. Anyway, I felt fine for awhile, but when I got home (from my sister’s house), I started feeling dizzy. My sitting blood pressure was about 95/60 which is super low for me. The earlier blood pressure reading must have been an error and I should have not taken the Nifedipine. I am trying to stay seated as much as possible since each time I stand up, I feel dizzy. Hopefully it will pass soon. At dialysis, it usually takes 30 minutes to recover if I have hypotension post-dialysis.