13th March is
observed as World Kidney Day
Hypertension and chronic
kidney disease - Cause and consequence
The kidney is both a cause
and victim of hypertension. High blood pressure is a key factor responsible for
deterioration of kidney function. In cases of resistant hypertension the most
common cause would be preexisting kidney disease, however it is often
underappreciated.
Chronic kidney
disease (CKD)
CKD is a progressive loss
in kidney function over a period of months or years. Each of your kidneys has
about a million tiny filters, called nephrons. If nephrons are damaged, they
stop working. For a while, healthy nephrons can take on the extra work. But if
the damage continues, more and more nephrons shut down. After a certain point,
the nephrons that are left cannot filter your blood well and are less able to
do the following jobs to help maintain health:
·
Remove wastes and extra fluid from your body
·
Release hormones that help to
Control blood pressure
Promote strong bones
Keep the right balance of
important chemicals in your blood, such as sodium,
potassium, phosphorus and
calcium
Maintain the body’s balance of acid and base.
When your kidneys are not
working well, wastes can build to high levels in your blood and make you feel
sick. Even before that, you may develop complications like high blood pressure,
anemia (low blood count), weak bones, poor nutritional health and nerve damage.
Kidney disease also makes you more likely to develop heart and blood vessel
disease. These problems may happen slowly, over a long period of time, often
without symptoms. CKD may eventually lead to kidney failure requiring dialysis
or a kidney transplant to maintain life. Early detection and treatment can
prevent or delay these complications. Diabetes and hypertension are the common
causes of chronic kidney disease.
High blood pressure or hypertension
Blood pressure is the
force of your blood against the walls of your blood vessels as your heart pumps
blood around your body. If this pressure becomes too high, you are said to have
high blood pressure, or hypertension.
How do know if your blood
pressure is too high?
The only way to tell if
your blood pressure is too high is to have it measured. High blood pressure
usually causes no symptoms. That is why it has been called a “silent killer.” A
single high reading may not mean you have high blood pressure. It should be
confirmed on follow-up visits to your doctor or clinic. Normal blood pressure
in adults 18 and older is less than 120/80. People, who have blood pressure
between 120 and 139 for the top number, or between 80 and 89 for the bottom
number, may be more likely to develop high blood pressure unless they take
steps to prevent it. In general, blood pressure that stays at 140/90 or higher
is considered high. However, for people who have diabetes or CKD, a blood
pressure of 130/80 or higher is considered high.
You have high blood
pressure but not sure if you have CKD. What should you do?
Everyone who has high
blood pressure has an increased chance of developing CKD. You should ask your
doctor about having the following tests:
·
A blood test for creatinine, a waste product
from muscle breakdown: This should be used to calculate your glomerular
filtration rate, or GFR. Your GFR is a measure of your level of kidney
function. If your GFR is too low, it may mean your kidneys are not able to
remove enough wastes and extra fluid from your blood.
·
A urine test for protein: Persistent protein
in the urine is a sign of kidney damage.
·
A urine test to check for red blood cells and
white blood cells
How are high blood
pressure and kidney disease related?
They
are related in two ways:
1. High blood pressure is
a leading cause of CKD.
Over time, high blood pressure can
damage blood vessels throughout your body. This can reduce the blood supply to
important organs like the kidneys. High blood pressure also damages the tiny
filtering units in your kidneys. As a result, the kidneys may stop removing
wastes and extra fluid from your blood. The extra fluid in your blood vessels
may build up and raise blood pressure even more.
2. High blood pressure can
also be a complication of CKD.
Your kidneys play a key role in
keeping your blood pressure in a healthy range. Diseased kidneys are less able
to help regulate blood pressure. As a result, blood pressure increases.
Following your treatment plan and keeping your blood pressure controlled can
help keep your kidney disease from getting worse and prevent heart disease.
Things we can do to
control hypertension and prevent kidney diseases
·
Exercising regularly
·
Eating a low-salt diet
·
Eat healthy and keep your weight in check
·
Adequate fluid intake
·
Monitoring blood pressure, cholesterol and
glucose levels and keeping them in normal range
·
Taking your antihypertensive medications
correctly as prescribed by your doctor
·
Not smoking
·
Avoiding non-steroidal anti-inflammatory
drugs (NSAIDs) and other drugs which cause kidney damage
·
Getting your kidney function tests regularly
Dr. B. T. Anil Kumar, Consultant
Nephrologist, BGS Global Hospitals
Courtesy
:www.frontrunnerindia.com