How Does High Blood Pressure Damage Kidneys

The Link Between High Blood Pressure And Kidney Health

High blood pressure increases the risk of developing kidney disease and causing permanent damage to your kidneys. Damaged kidneys cannot filter blood as well as they should. As a result, excess fluid and waste from the blood remain in the body and may cause other health problems. Controlling your blood pressure can help prevent kidney disease, or help keep it from getting worse.

What Is High Blood Pressure?

Blood pressure is the measurement of the force of blood against your artery walls as it flows through your body. High blood pressure, also called hypertension, means the force against your artery walls is consistently too high.

Blood pressure readings use two numbers. Systolic measures how much pressure your blood is exerting when your heart beats. Diastolic measures how much pressure your blood is exerting when your heart is between beats. Blood pressure readings are typically expressed as systolic “over” diastolic.

High blood pressure is typically 130 or higher systolic pressure and 80 or higher diastolic pressure.

How Do Your Kidneys Work?

• Damaged kidneys fail to regulate blood pressure. Healthy kidneys produce a hormone called aldosterone to help the body regulate blood pressure. Kidney damage and uncontrolled high blood pressure each contribute to a negative spiral. As more arteries become blocked and stop functioning, the kidneys eventually fail.

Protect Your Kidneys by Managing Your Blood Pressure

• Eat a healthy, low-salt diet

• Do regular physical activity

How Can High Blood Pressure Affect The Health Of My Kidneys

Known as renal hypertension, this type of high blood pressure needs to be diagnosed and treated as soon as it is identified to prevent decreased blood flow and potential loss of function to a kidney. If the blockage becomes severe, blood flow to the kidney may stop completely, resulting in kidney failure.

Excellent imaging tests are now available to diagnose renal hypertension, as are low-risk treatments to improve blood flow to the kidney and preserve kidney function.

High blood pressure is a serious health condition that needs to be controlled, most often with medication, to prevent negative effects on organs throughout the body. However, about 1 out of 20 people have high blood pressure caused by narrowed or blocked arteries leading to the kidneys

Can Hbp Cause Kidney Failure

Your kidneys and your circulatory system depend on each other for good health. The kidneys help filter wastes and extra fluids from blood, and they use a lot of blood vessels to do so. When the blood vessels become damaged, the nephrons that filter your blood dont receive the oxygen and nutrients they need to function well. This is why high blood pressure is the second leading cause of kidney failure. Over time, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden. These damaged arteries are not able to deliver enough blood to the kidney tissue.

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What Causes Secondary High Blood Pressure

Causes of secondary high blood pressure include:

• Kidney disease, such as narrowing of the kidney arteries.
• Certain medicines, such as birth control pills, amphetamines, appetite suppressants, some antidepressants, steroids, and some non-steroidal anti-inflammatory drugs .

Your doctor may suspect that you have secondary high blood pressure if:

• Your blood pressure has suddenly gone up since it was last checked.
• You are young and your blood pressure is 160/100 or higher.
• You have had many treatments and medicines for high blood pressure, but it is still 160/100 or higher.
• You have symptoms of health problems that may raise blood pressure.
• Your kidneys dont work as well as they should.

How Does Eating Diet And Nutrition Affect High Blood Pressure And Kidney Disease

Following a healthy eating plan can help lower your blood pressure. Reducing the amount of sodium in your diet is an important part of any healthy eating plan. Your health care professional may recommend the Dietary Approaches to Stop Hypertension eating plan. DASH focuses on fruits, vegetables, whole grains, and other foods that are healthy for your heart and lower in sodium, which often comes from salt. The DASH eating plan

• is low in fat and cholesterol
• features fat-free or low-fat milk and dairy products, fish, poultry, and nuts
• suggests less red meat, sweets, added sugars, and sugar-containing beverages
• is rich in nutrients, protein, and fiber

A registered dietitian can help tailor your diet to your kidney disease. If you have congestive heart failure or edema, a diet low in sodium intake can help reduce edema and lower blood pressure. Reducing saturated fat and cholesterol can help control high levels of lipids, or fats, in the blood.

People with advanced kidney disease should speak with their health care professional about their diet.

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Chronic Kidney Disease And Hypertension: A Destructive Combination

Leticia Buffet, PharmDAssistant Professor, Department of Pharmacy PracticeRegis University School of PharmacyDenver, Colorado

Charlotte Ricchetti, PharmD, BCPS, CDEAssistant Professor, Department of Pharmacy PracticeRegis University School of PharmacyDenver, Colorado

US Pharm

Chronic kidney disease is defined as persistentkidney damage accompanied by a reduction in the glomerular filtrationrate and the presence of albuminuria. The prevalence of CKD hassteadily increased over the past two decades, and was reported to affectover 13% of the U.S. population in 2004.1 In 2009, more than570,000 people in the United States were classified as having end-stagerenal disease , including nearly 400,000 dialysis patients andover 17,000 transplant recipients.2 A patient is determinedto have ESRD when he or she requires replacement therapy, includingdialysis or kidney transplantation. The rise in incidence of CKD isattributed to an aging populace and increases in hypertension ,diabetes, and obesity within the U.S. population. CKD is associated witha host of complications including electrolyte imbalances, mineral andbone disorders, anemia, dyslipidemia, and HTN. It is well known that CKDis a risk factor for cardiovascular disease , and that a reducedGFR and albuminuria are independently associated with an increase incardiovascular and all-cause mortality.3,4

Renal Hypertension/renal Vascular Disease

Approximately five percent of people with hypertension or high blood pressure suffer from renal or renovascular hypertension, caused by narrowing or blockage in the arteries to the kidneys. With this blockage, the kidneys see a reduction of blood pressure and compensate for it by causing a rise in overall blood pressure, resulting in systemic hypertension. Early in its course, this hypertension can be treated with medication. However, as the blockage worsens, hypertension may become severe and difficult to control, even with multiple medications. Furthermore, it may result in sudden spikes in blood pressure, which can be extremely dangerous. In these cases, treatment of the underlying blockage may help eliminate or significantly reduce the hypertension to allow better control with fewer medications.

Hypertension itself can have a devastating effect on the kidneys . Exposure to abnormally high blood pressure over time will lead to kidney damage and a reduction in its ability to function normally. Because damage to the kidneys may not show up on routine blood tests until it is severe and possibly irreversible, early diagnosis and treatment are critical to protecting renal function.

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Medications That Can Harm The Kidneys

No matter what kind of medicine you take, whether OTC or prescription, it is destined to take a trip through your kidneys. Taking a drug the wrong way or in excessive amounts can damage these vital, bean-shaped organs and lead to serious complications. In the worst-case scenario, it could necessitate a kidney transplant.

Compared with 30 years ago, patients todayhave a higher incidence of diabetes and cardiovascular disease, take multiple medications, and are exposed to more diagnostic and therapeutic procedures with the potential to harm kidney function, according to Cynthia A. Naughton, PharmD, senior associate dean and associate professor in the department of pharmacy practice at North Dakota State University. All of these factors are associated with an elevated risk of kidney damage.

An estimated 20% of cases of acute kidney failure are due to medications. The technical term for this scenario is nephrotoxicity, which is growing more common as the aging population grows, along with rates of various diseases.

The kidneys get rid of waste and extra fluid in the body by filtering the blood to produce urine. They also keep electrolyte levels balanced and make hormones that influence blood pressure, bone strength and the production of red blood cells. When something interferes with the kidneys, they cant do their job, so these functions can slow down or stop altogether.

What Can I Do To Help Control My High Blood Pressure

A healthy lifestyle is key to helping control any type of hypertension. Making changes in daily habits can help, such as:

• Eating a heart-healthy diet: Choose fruits, vegetables, grains and low-fat dairy foods.
• Exercising regularly, at least 30 minutes a day of moderate activity, such as walking .
• Keeping your weight under control: Check with your healthcare provider for a weight-loss program, if needed.
• Quitting smoking, if you smoke.
• Cutting back on alcoholic drinks.
• Limiting caffeine intake.
• Limiting sodium in your diet: Read nutrition labels on packaged foods to learn how much sodium is in one serving.
• Reducing and avoiding stress when possible: Many people find that regular meditation or yoga helps.

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What Is The Prognosis For Hypertension

The underlying disease that caused hypertension to develop must be cured or controlled. Long-term success depends on whether or not this is possible.

“Even those conditions can be managed successfully in many cats.”

If the cat has kidney, heart, or thyroid disease, it is important to treat those conditions aggressively. Hyperthyroidism is curable, as is thyrotoxic cardiomyopathy secondary to hyperthyroidism. Hypertrophic cardiomyopathy from other causes and chronic kidney failure are not. However, even those conditions can be managed successfully in many cats.

If the cat has blindness due to detached retinas, an immediate medical emergency exists. Blood pressure must be lowered quickly in order to restore vision. If the retina remain detached for more than a day or two, the prognosis is poor for a return of normal vision. Therefore, the key to a successful outcome is rapid diagnosis and early administration of medication to lower blood pressure.

Contributors: Ryan Llera, BSc, DVM Ernest Ward, DVM

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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The Need To Monitor Kidney Function With Certain Drugs

Experts have suggested that after the initial assessment of kidney function, physicians should consider regular monitoring after starting or increasing the dosage of drugs associated with nephrotoxicity, especially those used chronically in patients with multiple risk factors for impaired kidney function, Dr. Naughton noted. If there is any sign of kidney harm, the provider should review the medications you are taking in order to identify which one is causing the problem.

If multiple medications are present and the patient is clinically stable, physicians should start by discontinuing the drug most recently added to the patients medication regimen. Once that has been taken care of, further harm to the kidneys may be minimized by keeping blood pressure stable, staying hydrated, and temporarily avoiding the use of other medications that may cause nephrotoxicity.

These safety tips can ensure you get the care you need while keeping your kidneys safe. That way, they can tend to essential functions like keeping things flowing .Originally published May 11, 2017

What Is Renal Hypertension

Renal hypertension is high blood pressure caused by the narrowing of your arteries that carry blood to your kidneys. It is also sometimes called renal artery stenosis. Because your kidneys are not getting enough blood, they react by making a hormone that makes your blood pressure rise.

This condition is a treatable form of high blood pressure when properly diagnosed.

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Diabetes High Blood Pressure And Kidney Disease

High blood pressure is one of the principal causes of kidney disease and kidney failure. When blood pressure is high, there is a large amount of tension inside the blood vessels that leads to damage. These vessels may constrict , which can cause a heart attack, stroke, or kidney failure.

High glucose and high cholesterol can also damage blood vessels. Thus people with diabetes who also have hypertension are at especially high risk for blood vessel damage. It usually takes years for blood vessels to completely constrict, and damage to blood vessels can be slowed down or somewhat reversed with treatment.

Diagnosis

Diagnosis of high blood pressure can only be done by having your blood pressure measured by a person trained in taking blood pressures. Usually, there are no obvious symptoms that indicate you have high blood pressure. If you have diabetes, the blood pressure is considered high if it is greater than 130/80.

Your blood pressure should be measured on multiple occasions, as blood pressure can vary throughout the day and it is normal to have occasional readings greater than 130/80. Blood pressure generally peaks in the middle of the day, and is lowest at night while you are sleeping. It is best to take blood pressure from the left arm, if possible, and should be taken after you have rested for 5-10 minutes. Your left arm should rest comfortably at heart level.

How Does High Blood Pressure Cause Kidney Disease

Your kidneys are made of tiny blood vessels that help clean your blood. When you have high blood pressure, the blood flows through these blood vessels with a lot of force. This can harm these blood vessels and cause kidney disease. However, high blood pressure can also be a symptom of kidney disease. Kidneys help your body control your blood pressure. When high blood pressure damages your kidneys, they cannot control your blood pressure very well.

You will not be able to feel if high blood pressure has hurt your kidneys. The only way to know is to be tested. Learn more about the tests for kidney disease.

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What Procedures May Help Treat Renal Hypertension

Angioplasty with stenting is an invasive procedure that helps blood flow more freely through the artery to the kidney. It is an option for those who have:

• Severe narrowing of the renal artery.
• Blood pressure that cannot be controlled with medicines.
• Kidneys that are not working well and are rapidly becoming worse.

In an angioplasty, a healthcare provider inserts a catheter into a small puncture over an artery in the arm or groin. This catheter carries a tiny inflatable balloon with it to the blocked area. There, the balloon is inflated and deflated several times to flatten the plaque against the artery walls, widening the vessel. After the procedure, the balloon and catheter are removed from the body. Stenting is usually needed in addition to angioplasty.

With stenting, a tiny mesh tube, called a stent, is inserted by the catheter. Just like the balloon in an angioplasty, the stent is guided to the narrowed area of the renal artery and placed to provide support, keeping the artery open. The stent is left in place permanently.

Role Of Endothelial Dysfunction

Endothelial cells are metabolically very active and the integrity of the endothelial layer has a pivotal role in many aspects of vascular function, that is, control of vasomotor tone and permeability. Activation of endothelium by elevated BP is followed by endothelial dysfunction, which finally results in endothelial disintegration if the offending stimulus lasts longer. At the end, disappearance of whole vessels may result in reduction of tissue perfusion and consequent hypoxia. In patients with CKD, the endothelium has a pivotal role not only with respect to their cardiovascular morbidity and mortality but also with regard to disease progression. It has become clear from experimental studies that vascular rarefaction in the capillary system of the renal medulla, as a result of endothelial damage, is a central step toward tissue hypoxia and kidney damage. Here, reduced availability of NO as a result of reduced synthesis by endothelial cells is thought to be a key event underlying vascular damage. An increase in blood levels of endogenous inhibitors of NO synthase, such as asymmetric dimethylarginine, has been reported to be an important mechanism related to reduced NO availability and accelerated renal damage progression in CKD hypertensive patients.

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Can High Blood Pressure Cause Kidney Disease

Kidneys use blood vessels to clean your blood of wastes, toxins and excess fluid. High blood pressure means that high pressure is consistently being exerted against the walls of arteries throughout the body, which can damage blood vessels over time. Damage to blood vessels, including the hardening and narrowing of arteries around the kidneys, can prevent your kidneys from cleaning bloodeventually leading to kidney disease.

Kidney disease or kidney failure due to high blood pressure may take years to develop. If you are diagnosed with kidney disease, it’s important to know that there are things you can do to manage CKD and thrive.

Lifestyle Changes For Kidney Health

If youve been diagnosed with CKD, The first thing we tell everybody to do is try to control their diabetes and high blood pressure, to prevent further damage, says Leisman.

The good news: Many of the healthy habits that can help you manage diabetes and high blood pressure, such as eating a balanced diet and exercising regularly, can also help keep your kidneys healthy and stop CKD from getting worse.

Once kidney function is lost, it cannot be restored. But there are steps you can take to prevent further damage and slow the progression of CKD.

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