Sartans, Side Effects and My CKD Journey

Hi everyone, where ever you are in the world!

This is a post about blood pressure medication, specifically Sartans. Have you ever taken blood pressure medication with the name ending 'sartan'?

There are many sartans including Candesartan, Losartan, and Olmesartan, which I have taken myself. Nephrologists like their patients to take this type of blood pressure medication for 2 reasons that I am aware of. They lower blood pressure but also they help reduce proteinuria, aka albuminuria, which is common in people with CKD. 

I shied away from taking sartans and stuck with the Labetalol I had been prescribed during pregnancy (the first time I ever needed blood pressure medication). That was until my Dad died of a heart attack. He died at home and I immediately set off on the 60 mile journey by train to see him before he was taken away by the silver van waiting outside. When I got there his medication was on the bed by his feet. It was a poignant moment reminding me how fragile life was and brought back the phrase one nephroligst had told me "You will die young if you don't take your medication". I was scared and I took my first sartan that day. This was 6 years ago.

My experience of these medications has been mixed. They lower my protienuria and blood pressure but the side effects for me include dry mouth, depression, loss of sexual desire and anxiety. Everyday is a struggle, and honestly I feel like a more stressful person to be around when I take them!

Sartans are known to lower GFR by competing with creatinine for excretion via the kidney. My GFR reduced more than expected but not enough to be recommending diffident blood pressure medication. Recently I have asked my nephrologist for a different medication (not sartans) but I was wary of the side effects from the Indapamide I was offered.

After some Google research, yes I know it's never recommended ;), I have written to my nephrologist asking if I can try Carvediolol. My reasoning being that it is an A blocker as well as B blocker, and also has vasodialting effects See information here, treating high blood pressure through various mechanisms, 3 pills in one 😅. Carvediol has also been shown to reduce proteinuria See here.

I also wrote to my GP at the same time, hoping I could get a prescription sooner as I only speak the nephrologist every 3 months. I got my prescription, but asked to wait for confirmation from my nephrologist before starting. I waited 2 weeks but no response yet (this is Uk NHS) and honestly, I was desperate to try something else so have started the carvediol at half dose 6.25mg once daily. I DO NOT RECOMMEND OTHERS DO THIS, JUST SHARING MY EXPERIENCE. PLEASE SPEAK TO YOUR DOCTOR BEFORE CHANGING MEDICATION.

So far so good ish. Blood pressure is in range, less depressed, feeling more me, but there are some side effects, for example mild headache and nausea at times. What has pleased me the most is that I am not waking up in the night. I can't remember how long it has been since I slept through!

I hope to post an update once I have spoken with my nephrologist. Hopefully I won't end up back on the Sartans but have to be realistic and wait to see how I feel over time plus the results of future blood and urine tests to see the outcome of changing Meds.