High Blood Pressure and Chronic Kidney Disease: What to Know
Scripps nephrologist explains how hypertension can damage kidneys
Scripps nephrologist explains how hypertension can damage kidneys
Unlike many chronic health problems, high blood pressure typically has no symptoms. The same is true of chronic kidney disease. Yet millions of Americans are living with one or both illnesses without realizing it. Without treatment, both can be life-threatening.
Fortunately, both conditions can often be detected and treated early, which helps prevent serious complications. In this video, San Diego Health host Susan Taylor talks with Andrew King, MD, a nephrologist at Scripps Clinic, about the relationship between hypertension and chronic kidney disease.
How high blood pressure affects your kidneys
Nearly half of adults in the United States have high blood pressure, also called hypertension, but many aren’t aware of it.
“High blood pressure is called ‘the silent killer’ for a reason,” says Dr. King. “The only way to know you have it is to measure it with a blood pressure cuff on your arm. That’s why regular blood pressure screenings are so important.”
As blood pressure increases, it puts more stress on blood vessels. Even if you feel healthy, elevated blood pressure can slowly damage blood vessels throughout your body, increasing your risk of heart disease, stroke and organ damage. Your kidneys, which contain millions of tiny blood vessels, are especially sensitive to increased blood pressure.
“The smallest blood vessels within the body, whether in the brain, the heart or the kidney, do not appreciate very high blood pressure,” Dr. King says. “Over time, that elevated blood pressure can damage all of these organs.”
At the same time, because your kidneys play a key role in regulating blood pressure, kidney disease can make controlling blood pressure even harder. When kidney function declines, blood pressure often rises. That elevated blood pressure then causes even more kidney damage, creating a vicious cycle.
“High blood pressure when you have kidney disease is particularly damaging for the kidneys,” Dr. King says. “Control of it is crucial to avoid progressive loss of kidney function and ultimately the need for dialysis.”
Chronic kidney disease often develops quietly
Anyone can develop kidney disease, but certain groups face a higher risk. These include people with:
- Diabetes
- High blood pressure
- Heart disease or heart failure
- Obesity
- A family history of chronic kidney disease
- A history of smoking
Black or African American people are disproportionately affected by chronic kidney disease.
Diabetes remains the leading cause of chronic kidney disease in the United States, but lifestyle factors can also have a significant impact on kidney health.
Like hypertension, chronic kidney disease rarely causes symptoms in its early stages. While more than 30 million Americans are estimated to have some degree of kidney disease, many don’t know it. The only way to diagnose chronic kidney disease is through blood and urine tests.
As kidney disease progresses, people may begin to experience fatigue, poor appetite or muscle cramps. Unfortunately, by the time symptoms develop, kidney damage may already be advanced.
Without treatment, some patients eventually require kidney replacement therapy, including dialysis or a kidney transplant.
Protecting kidney function with treatment and prevention
Dr. King says the goal of treatment is to prevent the need for replacement therapy.
“There is no question that treating high blood pressure is the critical step,” he says. “There is an array of medicines that are not super expensive, have relatively few side effects and, if taken correctly, can actually protect your kidneys and slow down the loss of kidney function.”
Prevention also can help. While some risk factors can’t be changed, many can. Dr. King encourages patients to focus on healthy lifestyle choices, including:
- Exercising regularly
- Maintaining a healthy weight
- Eating a Mediterranean-style diet rich in fruits and vegetables
- Limiting saturated fats and excess red meat
- Not smoking
- Taking prescribed medications as directed
“These habits benefit much more than your kidneys,” he says. “They also improve heart health, blood sugar control and overall well-being.”
In addition, most adults should have a routine health visit and blood pressure screening at least once a year. People with diabetes, obesity, heart disease or other risk factors may need more frequent checkups and kidney screening with simple blood and urine tests.
These simple screenings can make a tremendous difference because kidney disease is often treatable when caught early. Advances in medications, combined with healthy lifestyle choices, are helping more people preserve kidney function and avoid dialysis than ever before.
“I find that for those who really take control of their lives and their diet and exercise, it pays off in ways that are extraordinary,” Dr. King says. “And the fortunate thing is that there are lot of new tools that we can use to keep your kidneys safe.”
Listen to the podcast on high blood pressure and chronic kidney disease
Listen to the podcast on high blood pressure and chronic kidney disease
Follow San Diego Health on iTunes for the latest episodes on new medical technologies and wellness tips. We’re also on SoundCloud and Spotify.