Q: I am a 37-year-old lady. I have partial epilepsy, and have been taking anticonvulsant drugs for the past 25 years. Different medicines taken during these years are Eptoin, Tegretol, Sodium Valproate, etc. Three years back I got high blood pressure. It is said to be primary renal hypertension. I was on telsar and cardace. Now recently my blood urea level has gone up to 160 and creatinine level to 4.6. The reason could not be identified. What could be the cause for such an increase? What should I do to see that the levels do not go up further? Will a controlled diet help?

A:Two types of kidney problems can lead to hypertension:

1. The kidneys are damaged due to some other cause and the creatinine slowly increases with passage of time. The kidney failure leads to high blood pressure.
2. There are narrowings in the tubes taking blood to the kidneys. This narrowing can be found out by special ultrasound test called duplex or by a CT angiogram or MRA.

Your doctor can easily tell you which category you belong to. If it is due to kidney damage, then BP has to be controlled very well because the increased pressure may further accelerate kidney damage. The primary cause of kidney failure can be ascertained by the nephrologist. If there are narrowings in the kidney tubes, blood pressure and to some extent renal failure can be reversed by opening up the narrowings with balloon angioplasty. Diet in renal failure consists of decreasing protein and salt.