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.
What Are The Signs And Symptoms Of Chronic Kidney Disease
Early kidney disease is a silent problem, like high blood pressure, and does not have any symptoms. People may have CKD but not know it because they do not feel sick.
A person’s glomerular filtration rate is a measure of how well the kidneys are filtering wastes from the blood. GFR is estimated from a routine measurement of creatinine in the blood. The result is called the estimated GFR .
Creatinine is a waste product formed by the normal breakdown of muscle cells. Healthy kidneys take creatinine out of the blood and put it into the urine to leave the body. When the kidneys are not working well, creatinine builds up in the blood.
An eGFR with a value below 60 milliliters per minute suggests some kidney damage has occurred. The score means that a person’s kidneys are not working at full strength.
Another sign of CKD is proteinuria or protein in the urine. Healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate a blood protein called albumin from the wastes. At first, only small amounts of albumin may leak into the urine, a condition known as microalbuminuria, a sign of failing kidney function.
As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria. CKD is present when more than 30 milligrams of albumin per gram of creatinine is excreted in urine, with or without decreased eGFR.
How Kidneys Influence Blood Pressure
The blood pressure in your body depends upon the following conditions:
- The force of contraction of the heart — related to how much the heart muscle gets stretched by the incoming blood.
- The degree to which the arteries and arterioles constrict — increases the resistance to blood flow, thus requiring a higher blood pressure.
- The circulating blood volume — the higher the circulating blood volume, the more the heart muscle gets stretched by the incoming blood.
The kidney influences blood pressure by:
- Causing the arteries and veins to constrict
- Increasing the circulating blood volume
Specialized cells are located in a portion of the distal tubule located near and in the wall of the afferent arteriole. The distal tubule cells sense the Na in the filtrate, and the arterial cells sense the blood pressure. When the blood pressure drops, the amount of filtered Na also drops. The juxtaglomerular cells sense the drop in blood pressure and the decrease in Na is relayed to them by the macula densa cells. The juxtaglomerular cells then release an enzyme called renin. Renin converts angiotensinogen into angiotensin I. Angiotensin I is then converted to angiotensin II by an angiotensin-converting enzyme , which is found mainly in the lungs. Angiotensin II causes blood vessels to contract — the increased blood vessel constrictions elevate the blood pressure.
As you can see, the kidneys perform many functions that are important to your body:
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How Do Diabetes And High Blood Pressure Cause Ckd
High blood sugar levels and high blood pressure can damage blood vessels throughout the body, including the ones in the kidneys. Those blood vessels can then become less efficient at filtering blood, and are not able to deliver oxygen and nutrients to kidney tissue.
This reduced blood supply to the kidneys can then further damage their filtering system, and damaged kidneys can cause a buildup of waste and fluid that increases blood pressure even more.
Diabetes, high blood pressure, and CKD can often go undetected for years, silently causing damage throughout the body, so its important to know your risk and see your doctor regularly to be screened for these conditions. Getting proper treatment is key, and managing one condition can help you better manage the others. If you have CKD, the best way to slow or prevent kidney damage is to reach your blood sugar and blood pressure goals.
What Can Hurt Our Liver
Many things can damage our liver, from something as simple as the medications and supplements we take to a variety of disease processes. These include the following:
- Tylenol ;:One-third of the cases of liver failure are due to Tylenol.;Risk is greatly reduced if less than 2,000 mg per day.;
- Anti-Inflammatories :;.3 to 3 people out of every 100,000 people.;Risk for liver toxicity with NSAIDs is low.;Ibuprofen has the safest profile regarding liver;damage.
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What Do The Kidneys Do
The kidneys have several jobs. One of the most important is helping your body eliminate toxins. The kidneys filter your blood and send waste out of your body in urine.
The kidneys are bean-shaped organs about the size of your fist. They sit under your ribcage, toward your back. Most people have two working kidneys, but people can live well as long as at least one is working correctly.
When the kidneys dont work effectively, waste products build up in your body. If this happens, you might feel sick. In the most serious situations, kidney failure can be life-threatening. However, many people can manage kidney failure with the right treatment.
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. It’s 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.
How To Prevent Or Slow Ckd
The best way to prevent CKD is to manage and treat conditions, such as diabetes and high blood pressure, that can damage your kidneys. Lifestyle changes, such as maintaining a healthy weight and not smoking, can also help. If you are at risk for CKD, talk to your doctor about how often you should get screened for the condition. Early detection and treatment are important in helping prevent CKD from progressing.
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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How Can I Prevent Or Slow The Progression Of Kidney Disease From High Blood Pressure
The best way to slow or prevent kidney disease;from high blood pressure is to take steps to lower your blood pressure. These steps include a combination of medicines and lifestyle changes, such as
- being physically active
- managing stress
- following a healthy diet, including less sodium intake
No matter what the cause of your kidney disease, high blood pressure can make your kidneys worse. If you have kidney disease, you should talk with your health care professional about your individual blood pressure goals and how often you should have your blood pressure checked.
How Is Kidney Disease Treated
The treatments will depend on the cause of your kidney disease and how mild or advanced your kidney disease is. Mild kidney disease can be managed by you and your GP. The treatments generally aim to stop it getting worse and to lower your risk of heart disease and stroke.
The most important thing is to keep your blood pressure under control. Your doctor will want to make sure that its lower than 140/90mmHg, and in some cases as low as 130/80 mmHg.
Changes to your diet and lifestyleA healthy lifestyle will help to keep your blood pressure and your kidneys healthy. For example, stopping smoking, being active, cutting down on alcohol, eating healthily and limiting the amount of salt you eat.
If your kidney disease is more advanced, your doctor may advise you to eat a special diet which reduces the amount of waste products your body produces, giving your kidneys less work to do.
Dont use salt substitutes such as Lo-Salt or SALTernative if you have kidney disease. They contain a lot of potassium and, if your kidneys arent working properly, potassium can build up which leads to further problems.
MedicinesYou might need medications to control your blood pressure, including ACE inhibitors and angiotensin receptor blockers. These can lower the risk of heart disease and stroke and help prevent damage to your kidneys. You might also need medications called statins for high cholesterol, insulin for diabetes, and medicines to prevent blood clots.
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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 .
- Hormone related diseases, such as hyperthyroidism, hypothyroidism, or Cushing’s disease.
- Drinking a lot of alcohol .
- Narrowing of the aorta .
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 don’t work as well as they should.
Why Is My Liver Important
The livers primary function is to filter the blood coming from the stomach and other digestive organs, to break down chemicals and drugs , and to secrete bile. Bile is needed to break down fat and fat-soluble vitamins.
A QUICK REVIEW OF BLOOD TESTS:;The blood tests that docs look at to evaluate the condition of the liver include the ALT, AST, GGT, Alkaline Phosphatase , and the Bilirubin.;In short:;If ALT and AST are more evaluated than the Alkaline Phosphate, it suggests damage to the liver cells.;The ALT is a more specific marker than the AST.;If Alk Phos are more elevated than the ALT and AST, it suggests damage to the bile system.
The MOST common causes of slightly elevated liver tests are:
- Overweight/Obesity/Metabolic Syndrome
. . . which brings us to NASH and;NAFLD .;Once more than 5% 10% percent of the livers weight is fat, then it is called a fatty liver .
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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.
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;.;
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High Blood Pressure & Kidney Disease
High blood pressure is one of the leading causes of kidney failure. Kidneys are the primary organ that control blood pressure along with the adrenal gland situated on top of the kidney. There are many causes for high blood pressure, and most of them are related to kidney and adrenal gland health. Kidney disease can cause high blood pressure, and high blood pressure can, in turn, cause kidney disease. Many nephrologists are specially trained to deal with difficult-to-control blood pressure and prevent kidney, heart and brain damage.
Recognizing The Symptoms Of Ckd
CKD doesnt typically cause any symptoms until kidney function has declined substantially, which is why its important to detect the condition well before any symptoms develop.
Part of the reason we have so much difficulty in diagnosing chronic kidney disease early is that people dont usually get symptoms until their kidneys are at maybe 20 or 30 percent function, says Leisman. Before that, The patient feels perfectly fine and might not go to the doctor.
Initial symptoms of CKD after kidney function has declined substantially, but before kidney failure occurs can also be mild or nonspecific. Thats another reason you shouldnt wait until you experience symptoms to get screened for CKD, especially if you have diabetes, high blood pressure, or other risk factors. As kidney function worsens, your symptoms may worsen or you may develop additional symptoms.
Talk to your doctor if you experience symptoms of CKD. If CKD is suspected, your doctor will ask about your medical history and conduct a physical exam. They may also perform tests, such as a blood test to measure the level of waste products in your blood or a urine test to check for protein, to help make a diagnosis.
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Why Care About Htn
If I honestly look back at my life, its pretty clear that up until my enlightenment a few years ago, I was always kind of a here and now guy. I never really focused on how my choices today could affect my tomorrow, my next year, or my next ten years. I have to say, its nice actually thinking about the future now and blood pressure is certainly something that we should focus on today in order to ensure a more content and healthier tomorrow.;
After all, having Hypertension can lead to:
- Loss or decreased vision
- Heart Failure
And if we get any of these, they can lead to other things like depression, lack of intimacy and difficulty with our relationships, pain, heart surgery, more medications, fatigue and inability to participate in activities that we want to participate in, and even an inability to speak, eat, or use our arms and legs. Not good.
Key Risk Factors For High Blood Pressure:
Family history: Having one or more family members with high blood pressure increases your risk profile.
Smoking:;Using tobacco raises your blood pressure. Chemicals in smoke can also damage the lining of your arteries, causing them to narrow and increase blood pressure.
Being overweight or obese:;The more you weigh, the greater likelihood of getting high blood pressure.
Physical inactivity:;People who are inactive tend to have higher heart rates, which makes the heart work harder and increases blood pressure.
Salt:;Too much salt can cause your body to retain fluid, which increases your blood pressure.
Race:;High blood pressure is particularly common among African-Americans, and often develops at an earlier age.
Chronic conditions:;Certain chronic problems such as high cholesterol, diabetes, kidney disease and sleep apnea can increase the risk of high blood pressure.
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.;