Ask a doctor on the topic of General medicine

Ask Lupus

November 13, 2018 | 20,00 EUR | answered by Dr. med. Frauke Gehring

Hello Mrs. Gehring, I have 2 questions regarding my lupus, after my routine check-up 2 weeks ago. I hope you can provide me with answers to both questions!

Regarding the 1st issue, my kidney, a biopsy was considered due to protein leakage (1g/24h), but otherwise my kidney is in good condition! After consulting with the head physician and with stable values, they did not suggest it again, but they want to lower my blood pressure with Cadesartan (132 to 85 when excited), as high blood pressure can also affect the kidney. I have taken several measurements with my own blood pressure monitor and the average is around 115 to 80! I discussed this with the doctor and without consulting the head physician, she told me to take the tablets (starting with 4 then 8mg), regardless!

Now I am wondering if this is the right decision and if I should take even more tablets, what is your opinion on this when my blood pressure is actually very good?

Furthermore, for the 2nd time since April, I have a slight phosphate deficiency, about 0.7. The doctor told me that it's nothing serious, but online it says that this never occurs in healthy individuals, so why do I have it? A bit silly, but is it far-fetched to assume that Lupus is causing a change in my lungs? By the way, I am feeling very well!

Thank you!

Dr. med. Frauke Gehring

Good day,

The questions are not so easy to answer without having the whole picture. I see little sense in administering such a tiny amount of candesartan with normal blood pressure values and would suggest a 24-hour measurement to determine if there is actually a high blood pressure that requires treatment (which is probably not the case). Sometimes Sartans are also given because they are supposed to improve kidney metabolism. I would also inquire if that is the reason.

Phosphate deficiency also occurs in healthy individuals, e.g. in cases of calcium or vitamin D deficiency. I would only become skeptical if these values are normal and phosphate remains consistently low. Since 0.8 is already normal, I would not be very concerned, and it does not indicate anything about the lungs.

Sincerely, Dr. Gehring