Hypertensive Kidney Disease - Causes, Symptoms, Diagnosis and Prevention

Hypertensive Kidney Disease

Dr.Suryanarayan Mandal profile Authored by Dr.Suryanarayan Mandal on 10 Apr 2014 - 17:09.

Hypertension or high blood pressure is one of the leading causes of Kidney disease and may lead to end stage renal disease if blood pressure is not controlled. Kidney diseases which can lead to hypertension are due to glomerulonephritis and renovascular disease (caused by significant obstruction in the flow of blood to kidney) . On the other hand essential hypertension or secondary hypertension can affect kidneys as target organ damage. Hypertension causes damage to the blood vessels and the filters disrupting the normal functioning of the kidneys affecting the excretion of waste material from the body.  The presentation of hypertensive kidney disease can be in form of acute kidney disease, rapidly progressive renal failure, or ischemic nephropathy.

There are many causes of hypertensive kidney diseases like essential hypertension(or idiopathic), renovascular (significant obstruction in the flow of blood to kidney)hypertension and endocrine causes of hypertension (like excessive  secretion of  hormones  like aldosterone, adrenaline, noradrenaline, corticosteroids etc. in our body)

Symptomatology consists of non-specific symptoms like headache, visual blurring, chest pain etc. Patients can have bland urine sediment, subnephrotic or nephritic proteinuria, high blood urea and serum creatinine, normal or small sized kidney and nephrosclerosis on kidney biopsy.

In the early stages of kidney disease there are no significant symptoms, however, a measure of GFR (glomerular filtration rate), creatinine (waste product) and protein in urine helps diagnosis of kidney damage.

Some patients will have leg swelling, low hemoglobin, loss of appetite, nausea and vomiting etc as damage to the kidney can result in accumulation of waste products in blood that will interfere with normal functioning of  our body systems.

One can suspect hypertensive kidney disease in the presence of hypertension,poor control of blood pressure, eye damage and cardiomagaly.  Diagnosis can be confirmed by kidney biopsy and also glomerular filtration rate, creatinine and protein in the urine.

African-American patients show more marked elevations in blood pressure. Diabetics are more prone to develop hypertensive kidney disease, over-weight and leading a sedentary lifestyle, poor diet and alcohol are some of the causes for developing high blood pressure and thereby damage to the kidney.  When systolic and diastolic blood pressures are more than 140/90 mmHg  it indicates high blood pressure. The normal reading should be 120/80 mm Hg mmHg .Blood pressure varies according to age and sex of an individual.

Proper control of blood pressure with anti-hypertensive agents like Angiotensine converting enzyme or Angiotensine receptor blocker in addition to other drugs can help.

Effective treatment of the hypertension usually slows progression of renal injury. It is not clear whether ACE inhibitors and angiotensin II receptor blockers are also protective in patients with benign nephrosclerosis without proteinuria.

Also eating iodine salt diet, fresh vegetables along with physical aerobic exercises can help in controlling blood pressure and maintaining a healthy fit self.

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.