By Rohit Pankhanyia, MD.

CONTENT SUMMARY:

​In this FKP Kidney Health blog post, we will discuss the connection between hypertension (high blood pressure) and CKD.

​The first part of the blog will explore the following topics:

• The Bidirectional Link

• Impact on Renal Blood Vessels

• Damage to Glomeruli

• Inflammatory Responses

Next, we’ll share how blood pressure control plays a role in: 

• Preserving Kidney Function

• Slowing Progression of CKD

• Preventing Complications

• Collaborative Care

Toward the end of the blog, we’ll share these practical tips for blood pressure

management: 

• Adopting a Heart-Healthy Diet

• Regular Physical Activity

• Medication Adherence

• Stress Management

As always, we’re grateful that you’re choosing to learn more about your kidney health 

on our blog. We hope these and other posts as part of our chronic kidney disease series motivate you to nurture your kidneys now and well into the future.

Unveiling the Link: Hypertension and Chronic Kidney Disease

Introduction

There’s an intricate connection between hypertension (high blood pressure) and chronic kidney disease (CKD). Why does this connection exist, and what can you do to ensure that you’re taking all the precautions necessary to protect your heart and kidneys? Your friends at Florida Kidney Physicians (FKP) will help you fully comprehend the connection between hypertension and CKD so you can keep these vital organs as healthy as possible.

Understanding the Relationship

​The relationship between hypertension and CKD does not go unnoticed by healthcare providers, which is all the more reason it shouldn’t go unnoticed by you. 

• The Bidirectional Link

You may have hypertension on account of CKD, or you may develop CKD on account of hypertension. Over time,uncontrolled high blood pressure can lead to kidney damage; conversely, kidneys that are not functioning as normal can cause elevated blood pressure levels. Hypertension can be both a cause and a consequence of CKD, which is why high blood pressure needs to be promptly treated through lifestyle modifications and/or prescription medications.

• Impact on Renal Blood Vessels

Hypertension has a physiological impact on the delicate blood vessels in your kidneys. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) notes on their “High Blood Pressure & Kidney Disease”webpage: “If your kidneys’ blood vessels are damaged, they may no longer work properly. When this happens, the kidneys are not able to remove all wastes and extra fluid from your body. Extra fluid in the blood vessels can raise your blood pressure even more, creating a dangerous cycle, and cause more damage leading to kidney failure.” When persistently high blood pressure narrows your bloodvessels, reducing blood flow and causing damage to the functional units of the kidneys (nephrons), your cardiovascular and renal health becomes increasingly jeopardized.

• Damage to Glomeruli

Hypertension can affect the glomeruli, which are the tiny blood vessels in your kidneys that are responsible for filtering waste. When untreated hypertension leads toglomerular damage, your kidneys will have a difficult time filtering and excreting waste products, and this can result ina buildup of toxins in your body. 

• Inflammatory Responses

Hypertension triggers inflammatory responses, especially within the kidneys. Chronic inflammation can contribute to fibrosis and scarring. This is concerning because ongoinginflammation compromises your kidney function and triggers health problems that extend far beyond the renal system.

Importance of Blood Pressure Control

​If your doctor confirms that you have hypertension, you’ll need to adhere to your customized treatment plan so you can get your blood pressure under control as soon as possible.

• Preserving Kidney Function

Your care team at FKP wants to reiterate that getting your blood pressure under control can preserve your kidney function and slow the progression of CKD. It’s imperative that your blood pressure levels stay within the normal rangeso further kidney damage can be prevented.

• Slowing Progression of CKD

Your commitment to regulating your blood pressure can slow the progression of CKD. Reducing excess strain on your kidneys mitigates the risk of reaching advanced stages of kidney disease. Advanced stages of CKD are more difficult to treat because your kidneys are getting closer and closer to failing. Survival of Stage 5 CKD requires kidney dialysis or a kidney transplant. 

• Preventing Complications

By getting your blood pressure under control, you can rest assured that you’re doing your part to preventcomplications associated with CKD. Common complications of CKD include cardiovascular diseases(heart disease), an increased risk of cardiovascular events (heart attack and stroke), and fluid and electrolyteimbalances.

• Collaborative Care

A collaborative approach and open communication between you and your healthcare providers can help youachieve—and maintain—optimal blood pressure levels.You’re always encouraged to ask questions, express your concerns, and report new or worsening symptoms. Schedule regular check-ups, adhere to your prescribed medications, and follow through with any diagnostic tests that have been ordered for you so you can stay vigilant and take the steps necessary to prolong your kidney function. 

Practical Tips for Blood Pressure Control

​Here are some excellent ways to control your blood pressure. 

• Adopting a Heart-Healthy Diet

Eating a heart-healthy diet lowers your risk of experiencing a heart attack and helps regulate your blood pressure. American Heart Association (AHA) suggests implementing the DASH (Dietary Approaches to Stop Hypertension) eating plan, which is specifically “designed to help you manage blood pressure. Emphasizing healthy food sources, it also limits: red meat, sodium (salt), sweets, added sugars and sugar-containing beverages.” AHA adds that “in addition to being easy to follow, delicious and varied, the DASH eating plan is proven effective.” Talk to your doctor or a registered dietician about limiting your sugar andsodium intake, adding potassium-rich foods to your diet, and establishing a personalized diet that you'll enjoy and be able to closely follow. 

• Regular Physical Activity

Mayo Clinic notes that “regular physical activity can lower high blood pressure by about 5 to 8 mm Hg. As a general goal, aim for at least 30 minutes of moderate physical activity every day. For those who have hypertension, regular physical activity can bring blood pressure down to safer levels. Some examples of aerobic exercise that can help lower blood pressure include walking, jogging, cycling, swimming or dancing. Another possibility is high-intensity interval training. This type of training involves alternating short bursts of intense activity with periods of lighter activity. Strength training also can help reduce blood pressure. Aim to include strength training exercises at least two days a week.” Commit to 150 minutes of exercise per week so you can regulate your blood pressure and promote your kidney health. 

• Medication Adherence

If your doctor has prescribed antihypertensive medications, please be sure to take them exactly as directed. Medication adherence is a crucial component of blood pressure management because your medications are designed to effectively regulate your blood pressure and mitigate excess strain on your kidneys. If you have concerns or encounter unpleasant side effects, talk to your doctor so those issues can be addressed in a timely manner.

• Stress Management

Stress is a normal part of life, but too much stress can cause unhealthy spikes in your blood pressure. We invite you to find stress management techniques that work well for you. Consider meditating, deep breathing exercises, reading,listening to music, or calling a close friend. Managing stress can be a helpful strategy for preventing and managing high blood pressure.

Nurturing Kidney Health Through Blood Pressure Control

We hope this blog post helped you gain a clearunderstanding of the connection between hypertension and CKD. Our providers at FKP want to inspire you to foster a collaborative relationship with us so we can provide you withthe information, resources, and support you need to keep your blood pressure levels regulated and your kidneys healthy.

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