What Symptoms Or Signs Are Seen With Renal Hypertension
Although renal hypertension is hard to diagnose and usually has no symptoms, be aware of these signs:
- High blood pressure that is not controlled on three or more medications at their maximum doses, including a diuretic.
- High blood pressure at a young age.
- Stable high blood pressure that suddenly gets worse or is difficult to control.
- Kidneys that are not working well, which may occur suddenly.
- Narrowing of other arteries in the body, such as to the legs, the brain, the eyes and elsewhere.
- Sudden buildup of fluid inside the lungs, called pulmonary edema.
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Not Drinking Enough Water
Staying well hydrated helps your kidneys clear sodium and toxins from the body. Drinking plenty of water is also one of the best ways to avoid painful kidney stones. Those with kidney problems or kidney failure may need to restrict their fluid intake, but for most people, drinking 1.5 to 2 liters of water per day is a healthy target.
High Blood Pressure And Chronic Kidney Disease
Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body.
Blood pressure normally rises and falls throughout the day, but it can damage your heart and cause health problems if it stays high for a long time. Hypertension, also called high blood pressure, is blood pressure that is higher than normal.
Uncontrolled high blood pressure is the second leading cause of kidney failure in the US. Severe high blood pressure can harm kidney function over a relatively short period of time. Even mild forms of high blood pressure can damage kidneys over several years.
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How Will I Know If My High Blood Pressure Is Affecting My Kidneys
To know if your kidneys have been damaged, your doctor may do tests, including:
- Blood tests: To help find out how well your kidneys still work
- Urine tests: To check for blood and protein in your urine or other signs of problems
- Imaging tests: To look at your kidneys, such as an ultrasound, CT scan, X-ray or MRI
How Often Should I See My Doctor
Your CKD team will outline a treatment plan for you after you are diagnosed. Most patients come to the clinic 1 or 2 times per year. Well ask you to come in more often if:
You start a new medicine or we change your medicine dose.
Your kidney function is getting worse.
Your blood pressure is not controlled.
At each visit, we will test your blood and urine and measure your blood pressure.
DONT be afraid to ask questions. We are here to help you.
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What Medicines May Help Treat Renal Hypertension
If your healthcare provider suspects you might have renal hypertension, you most likely are already on medicines to help control your blood pressure. There are many different types of high blood pressure medications available. Everyone responds to medicine differently. Your healthcare provider will decide which type is best. Remember:
- Many times, more than one type of medicine may be needed.
- The amount and type of medicine may need to be changed from time to time.
- Take all medicines in the exact way your healthcare provider prescribed them.
The goal is to lower your blood pressure. In renal hypertension, two specific types of medications may work better to control your blood pressure:
- Angiotensin-converting enzyme inhibitors.
- Angiotensin receptor blockers .
These medications are rarely prescribed at the same time. In certain cases of renal artery stenosis where both arteries are narrowed, these medications may cause a decrease in kidney function. It is important that your healthcare provider check a blood test for your kidney function one to two weeks after starting or adjusting these medications. In addition to an ACE inhibitor or an ARB, a diuretic, or water pill, may be prescribed to help your kidneys remove extra fluid from the blood. The water pills will make you urinate more often.
How High Blood Pressure Can Damage Kidneys
High blood pressure the second leading cause of CKD is an increase in the force of blood as it flows through your blood vessels. Over time, that force can damage the tiny vessels in the nephrons, just as it can damage blood vessels throughout the body.
The vessels in the kidney are delicate, explains Dr. Leisman. Imagine two hoses: one is high pressure and one is low pressure. Both have water coming out, but the water coming from the high-pressure hose, over time, can lead to damage.
Leisman notes that treating high blood pressure is one of the cornerstones of preventing or slowing kidney damage. In fact, some of the most common drugs used to lower blood pressure are considered a standard treatment for CKD.
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Blood Tests For Kidney Disease
The best measure of kidney function is the glomerular filtration rate , which can be estimated from a blood test that checks the blood for creatinine .
A normal GFR result is higher than 90 mL/min/1.73 m2. If the result is persistently less than 60 mL/min/1.73 m2 for at least three months, this confirms that the person has chronic kidney disease.
Blood tests can reveal other abnormalities of kidney function, such as:
- high levels of acids
- high levels of potassium
- low levels of salt
- changes to the levels of calcium and phosphate.
Symptoms Of Kidney Disease
Kidney disease is called a silent disease as there are often few or no symptoms. In fact, you can lose up to 90 per cent of your kidneys functionality before experiencing any symptoms. Some signs and symptoms include:
- a change in the frequency and quantity of urine you pass, especially at night
- blood in your urine
- changes in the appearance of your urine
- puffiness around your legs and ankles
- pain in your back
- pain or burning when you pass urine
- high blood pressure.
If your kidneys begin to fail, waste products and extra fluid build up in your blood. This, and other problems, gradually leads to:
- tiredness and inability to concentrate
- generally feeling unwell
- bad breath and a metallic taste in the mouth.
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How Pain Raises Blood Pressure
Pain can acutely increase blood pressure. Hypertension is associated with a reduced sensitivity to pain.
When pain is detected by the nervous system it will activate a mechanism called the baroreceptor reflex. This system is what controls blood pressure. The reflex tells the body to constrict blood flow, which increases blood pressure. This will continue until the pain is no longer detected. This reduced sensitivity to pain will tell the baroreceptor reflex to relax blood vessels and lower blood pressure down to normal levels.
Imaging Tests For Kidney Disease
Tests that create various pictures or images may include:
- x-rays to check the size of the kidneys and look for kidney stones
- cystogram a bladder x-ray
- voiding cystourethrogram where the bladder is x-rayed before and after urination
- ultrasound sound waves are bounced off the kidneys to create a picture. Ultrasound may be used to check the size of the kidneys. Kidney stones and blood vessel blockages may be visible on ultrasound
- computed tomography x-rays and digital computer technology are used to create an image of the urinary tract, including the kidneys
- magnetic resonance imaging a strong magnetic field and radio waves are used to create a three-dimensional image of the urinary tract, including the kidneys.
- radionuclide scan.
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Stroke And Brain Problems
High blood pressure can cause the arteries that supply blood and oxygen to the brain to burst or be blocked, causing a stroke. Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities. A stroke can also kill you.
Having high blood pressure, especially in midlife, is linked to having poorer cognitive function and dementia later in life. Learn more about the link between high blood pressure and dementia from the National Institutes of Healths Mind Your Risks®external icon campaign.
How Common Are High Blood Pressure And Kidney Disease
Almost 1 in 2 U.S. adultsor about 108 million peoplehave high blood pressure.1
More than 1 in 7 U.S. adultsor about 37 million peoplemay have chronic kidney disease .2
High blood pressure is the second leading cause of kidney failure in the United States after diabetes, as illustrated in Figure 1.2
Almost 1 in 2 U.S. adultsor about 108 million peoplehave high blood pressure.
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Diabetes And Kidney Disease
About 20 to 30 per cent of people with diabetes develop a type of kidney disease called diabetic nephropathy. This is a serious disease and may worsen other diabetic complications such as nerve and eye damage, as well as increasing the risk of cardiovascular disease.
Diabetic nephropathy is the main cause of kidney failure .
How Does High Blood Pressure Hurt My Kidneys
High blood pressure makes your heart work harder and, over time, can damage blood vessels throughout your body. If the blood vessels in your kidneys are damaged, they may stop removing wastes and extra fluid from your body. The extra fluid in your blood vessels may then raise blood pressure even more. Its a dangerous cycle. High blood pressure is one of the leading causes of kidney failure, also commonly called end-stage renal disease . People with kidney failure must either receive a kidney transplant or go on dialysis. Every year, high blood pressure causes more than 25,000 new cases of kidney failure in the United States.
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When To See A Healthcare Provider
People will often assume that sudden flank pain is caused by a pulled muscle or overexertion, and, in many cases, it will be.
If the pain persists, worsens, or is accompanied by urinary symptoms or signs of infections, you should see your healthcare provider as soon as possible. This is especially true if you are experiencing high fever, chills, vomiting, or the inability to urinate.
Even if a kidney infection is mild, it can sometimes progress and lead to bacteremia if left untreated. This is a condition in which a local bacterial infection âspills overâ over into the bloodstream, causing systemic and potentially life-threatening symptoms, including irregular body temperatures, disruptions in breathing, a severe drop in blood pressure, and shock.
Given that acute pyelonephritis can strike in as little as two days, a rapid response is essential.
The same applies if you experience a dull but persistent pain alongside uncommon symptoms such as painful urination, chronic fatigue, or unexplained weight loss. None of these should be considered normal, and you shouldnât wait until there is visible blood in urine to seek care.
If you are pregnant, don’t assume that persistent back pain is pregnancy-related. Be cognizant if there is a dull ache across your lower back or along the sides of your back between the ribs and hips. If accompanied by symptoms of infection or changes in urination, call your healthcare provider immediately.
Blockage Of Blood To The Kidney
A blockage of blood to the kidney is called a renal infarction or a renal vein thrombosis. This happens when the blood supply to and from the kidney is suddenly slowed or stopped. There are several causes, including a blood clot.
Blood flow blockages to the kidney typically happens on one side. Symptoms include:
- severe side or flank pain
- lower back pain or ache
- stomach tenderness
- blood in the urine
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Prevention Of Kidney Disease
Medication and changes to lifestyle, along with an early referral to a kidney specialist , can prevent or delay kidney failure.
Heathy lifestyle choices to keep your kidneys functioning well include:
- Eat lots of fruit and vegetables including legumes and grain-based food such as bread, pasta, noodles and rice.
- Eat lean meat such as chicken and fish each week.
- Eat only small amounts of salty or fatty food.
- Drink plenty of water instead of other drinks. Minimise consumption of sugary soft drinks.
- Maintain a healthy weight.
- Stay fit. Do at least 30 minutes of physical activity that increases your heart rate on five or more days of the week, including walking, lawn mowing, bike riding, swimming or gentle aerobics.
- If you dont smoke, dont start. If you do, quit. Call the Quitline or ask your doctor for help with quitting.
- Limit your alcohol to no more than two small drinks per day if you are male, or one small drink per day if you are female.
- Have your blood pressure checked regularly.
- Do things that help you relax and reduce your stress levels.
A range of medication is available for high blood pressure. Different blood pressure medications work in different ways, so it is not unusual for more than one type to be prescribed. The dose may change according to your needs.
What Do Blood Pressure Numbers Mean
Blood pressure is measured using two numbers:
The first number, called systolic blood pressure, measures the pressure in your arteries when your heart beats.
The second number, called diastolic blood pressure, measures the pressure in your arteries when your heart rests between beats.
If the measurement reads 120 systolic and 80 diastolic, you would say, 120 over 80, or write, 120/80 mmHg.
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What Can I Do To Prevent Or Manage High Blood Pressure
Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about
- Getting at least 150 minutes of physical activity each week
- Not smoking
- Managing stress
Learn more about ways to manage and prevent high blood pressure.
In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure. Learn more about medicines for high blood pressure.
Talk with your health care team right away if you think you have high blood pressure or if youve been told you have high blood pressure but do not have it under control.
How Does High Blood Pressure Affect My Kidneys
Here is how high blood pressure can affect your kidneys:
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Does Kidney Disease Increase Blood Sugar Levels
We all know that kidney disease affects kidney function and causes an accumulation of toxins in the blood. Kidney Patients need to undergo dialysis or kidney transplant to excrete those toxins from blood vessels.
CRCHUM director Dr. Vincent Poitout reported that We identified molecular mechanisms that may be responsible for the increase in blood glucose levels in patients with non-diabetic kidney disease. Our observations in mice samples and in human samples show that the disease can cause secondary diabetes, from his research. He explained that chronic kidney patients without diabetes start to develop secondary diabetes because of a specific toxin in the bloodstream.
What Causes High Blood Pressure
High blood pressure usually develops over time. It can happen because of unhealthy lifestyle choices, such as not getting enough regular physical activity. Certain health conditions, such as diabetes and having obesity, can also increase the risk for developing high blood pressure. High blood pressure can also happen during pregnancy.
You can manage your blood pressure to lower your risk for serious health problems that may affect your heart, brain, kidneys, and eyes.
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Elevated Blood Pressure And Risk Of End
It had been known since the early days of Franz Volhard and Arthur Fishberg that renal disease and renal failure occur commonly in hypertensive patients. In the study of Perera , at a time when antihypertensive medication had not yet become available, a large proportion of patients with essential hypertension wound up in renal failure. This was later ascribed to the occurrence of malignant hypertension. With the advent of effective antihypertensive medication, malignant hypertension has become much rarer. In relatively short-term trials that clearly documented the cardiovascular benefit from antihypertensive medication, few if any cases with renal failure were observed. This led to an as yet unresolved dilemma.
There are authors who made strong statements such as: there are no reported cases of benign essential hypertensive patients with normal serum creatinine levels and no proteinuria who subsequently went on to develop renal failure . On the other hand, in the US and elsewhere, but with remarkable differences between countries , a high proportion of cases reaching end-stage renal disease with hypertension and a nondiagnostic clinical course are given the diagnosis of hypertensive nephropathy in the absence of renal biopsy and other more in-depth investigations.
What was the evidence available so far and what were its shortcomings?
Eberhard Ritz Feature Editor