High blood pressure is sometimes temporary. However, if the values are permanently higher than normal, a doctor must be consulted. Kidney disease, such as nephropathy, can result from untreated high blood pressure.
What is kidney disease (nephropathy)?
Kidney disease (nephropathy) develops in patients who suffer from high blood pressure and do not receive treatment or only receive inadequate treatment.
Since renal function and blood pressure interact with each other, chronic renal insufficiency develops as a secondary disease. On the one hand, blood pressure is regulated by hormone secretion by the kidneys. On the other hand, the kidneys are responsible for the fluid balance in the body. The interaction of both factors thus determines the blood pressure. See etaizhou for What does Bronchial Asthma Mean.
If there is persistent high blood pressure, the vascular system within the kidneys can be damaged. However, damage to the kidneys can also be the cause of high blood pressure. Kidney disease initially goes unnoticed. The lower the kidney function, the more problems there are.
Initially, patients feel tired and have less appetite. Headaches with nausea and vomiting may occur. In addition, there is the storage of tissue fluid (edema), combined with itching of the skin. This can appear bronze colored. As a result, kidney disease causes anemia (low blood count) and heart failure.
The cause of kidney disease is the slow calcification of the kidney vessels. If this occurs not only in the small capillaries but also in the large vessels, the kidneys are no longer supplied with sufficient blood. It compensates for this condition by releasing a larger amount of hormones, which, however, also increases blood pressure.
The smaller renal vessels increasingly lose their stability. The protein concentration in the urine is increased because the kidneys damaged in this way can no longer fulfill their function and filter the protein accordingly.
Symptoms, Ailments & Signs
Kidney disease (nephropathy) associated with high blood pressure is usually asymptomatic at the beginning. Only high blood pressure can cause unspecific symptoms, if at all. The patient then sometimes suffers from headaches, dizziness, blurred vision or tightness in the chest area. But even chronic high blood pressure often goes unnoticed because it does not always lead to symptoms.
Kidney damage is usually only diagnosed incidentally in this phase. During laboratory tests, increased concentrations of proteins are found in the urine. The constant breakdown of kidney tissue can be compensated over and over again for years by its regeneration. Only the tissue hardens, so that nephrosclerosis develops. If high blood pressure is left untreated, kidney damage will progress to the point where symptoms will eventually develop.
Due to the restricted kidney function, those affected then suffer from tiredness, exhaustion, poor performance, excruciating itching all over the body and headaches. In addition, nausea, vomiting and loss of appetite may occur. The skin becomes milky-coffee-colored or bronze-colored. Water can accumulate in the lungs. This often leads to severe shortness of breath.
The disease can lead to complete kidney failure. The patient either requires lifelong dialysis. In severe cases, a kidney transplant is also necessary. If there are sharp fluctuations in blood pressure, kidney failure can also occur suddenly with states of confusion, nausea, vomiting, coma or even seizures and heart failure. This is a very serious emergency situation that can quickly lead to death.
Diagnosis & History
Kidney disease, such as nephropathy, is first diagnosed by the doctor through an analysis of the urine. The more protein it contains, the further the damage to the kidney has progressed. By taking the anamnesis, the doctor receives additional information about the patient’s other complaints, which point the way to kidney disease and which can be confirmed by a subsequent laboratory test.
Healthy people should have less than 20ml/l of protein in their urine. Values between 20 and 200 mg/l indicate microalbuminuria and thus the onset of kidney disease. Values above this indicate advanced kidney disease. The blood test provides further information about the kidney function. Additional organ damage such as damage to the eyes and heart must be ruled out if kidney disease is diagnosed.
When kidney disease (nephropathy) is caused by high blood pressure, if left untreated, a vicious cycle can develop in which both nephropathy and high blood pressure continue to increase. This usually leads to serious complications. As mentioned earlier, high blood pressure is a cause of nephropathy. The kidney vessels are calcified and can no longer be adequately supplied with blood.
When the organism tries to increase blood flow to the kidneys, the blood pressure increases even further. However, the increased blood pressure exacerbates the existing kidney disease and, in extreme cases, can lead to kidney failure with the subsequent need for dialysis. If the high blood pressure is not treated, there is also a risk of total failure of one or even both kidneys.
However, it is not just the kidneys that are affected. The ever-increasing blood pressure also carries the risk of developing serious cardiovascular diseases. This increases the risk of heart attacks or strokes. However, complications of kidney disease (nephropathy) associated with high blood pressure can be very well avoided by early treatment of high blood pressure.
If kidney dysfunction due to high blood pressure is already present, blood pressure should be lowered to 130/80 mmHg to prevent kidney disease progression. If the kidneys are already severely damaged, this blood pressure value is still too high. In order to avoid further impairment of the kidney function, the blood pressure value must then ideally be reduced to below 125/75 mmHg in addition to the treatment of the nephropathy.
When should you go to the doctor?
If kidney disease is suspected, a doctor must always be consulted immediately. If such disorders are not recognized and treated in time, there is a risk of acute kidney failure. If the treatment is too late, the organ is often so severely damaged that the patient is dependent on dialysis, i.e. artificial blood washing. Kidney problems should therefore always be presented to a doctor promptly.
However, kidney diseases associated with high blood pressure are treacherous, since there are usually no symptoms at the beginning. At best, the patient will notice signs of high blood pressure themselves. Signs of this can be dizziness, blurred vision or non-specific headaches. Some patients also experience chest tightness. Anyone who often notices such symptoms should consult a doctor as a precaution.
In the advanced stage, more specific symptoms become noticeable in nephropathy associated with high blood pressure. A typical example is excruciating itching all over the body. Nausea, vomiting and discoloration of the skin often occur as well. At this point at the latest, a doctor must be consulted immediately. The symptoms should not be treated with over-the-counter medications as this can cause additional damage to the kidney.
Treatment & Therapy
Kidney disease caused by high blood pressure requires blood pressure to be kept at optimal levels. If kidney function is already impaired, blood pressure values should not exceed 130/80 mmHg to prevent further impairment of kidney function.
If you already have severe kidney disease, your blood pressure needs to be lowered even further. Values of up to 125/75 mmHg and below are considered ideal here. There are five different groups of drugs that are commonly prescribed to lower blood pressure. Because of the kidney damage in the patient, however, only drugs from the group of ACE inhibitors and AT1 antagonists can be used for treatment.
Regular checks of blood and urine values and of course the stability of the blood pressure values are necessary as a result. If the patient’s condition worsens due to the progression of the kidney disease and the kidney function is severely restricted, the kidney function must be replaced by permanent dialysis (blood washing). As a result, a kidney transplant may be necessary because dialysis and its side effects are a major burden in everyday life for patients with kidney disease.
Outlook & Forecast
The further course of the disease in the present disease depends on the intensity and length of the existing complaints from the blood pressure. In the case of short-term and temporary high blood pressure, a doctor is often not consulted. Existing health impairments are therefore not adequately diagnosed. High blood pressure that occurs repeatedly over a long period of time can have long-term consequences for the entire organism.
Without medical care, the future prospects for those affected are significantly worse. There is a gradual decrease in physical and mental strength. In addition to possible damage to the tissue, other symptoms can also occur that have a negative impact on general well-being. Impaired vision or headaches lead to further complications or irregularities in coping with everyday life. States of confusion or comatose developments can result.
In the event of an unfavorable course of the disease, the affected person is at risk of premature death at an advanced stage. Damage to the kidneys can lead to functional disorders of the organ. If there is no long-term therapy, dialysis or transplantation of a donor organ, life expectancy is significantly reduced. In addition, the affected person can die prematurely from sudden heart failure. The stress caused by high blood pressure can lead to organ damage in the heart and thus trigger an emergency situation.
Kidney disease can be prevented by checking blood pressure regularly. If your blood pressure is consistently high, you need treatment as soon as possible. Regular monitoring by the doctor is also important if you already have kidney disease, since the risk of developing other diseases of the cardiovascular system is correspondingly higher in this group of patients. In daily life, attention should be paid to low-salt food.
Depending on how the nephropathy has affected the kidneys, different types of follow-up care are necessary. If the disease is recognized and treated relatively early, the regular intake of blood pressure-lowering drugs is usually sufficient for the patient. If no serious side effects occur, no regular check-ups are necessary.
If the kidney function was already impaired as a result of the nephropathy or if it was even necessary to remove a kidney, an intensive follow-up examination is necessary. The focus here is on the adaptation of the patient to the reduced kidney performance. During the follow-up examinations, it is checked whether the remaining kidney capacity is sufficient to filter the blood sufficiently.
A doctor takes a blood sample and determines the levels of nutrients such as calcium and waste products. If the determined values are too high, the patients have to adjust their living conditions. Weight loss, a change in diet and light exercise are often the first steps. But habits such as smoking, excessive consumption of alcohol or sweets may also have to be given up.
If there is no improvement despite appropriate drug treatment and lifestyle changes, a kidney transplant may be necessary. After such a surgical intervention, the patients receive a therapy tailored to them so as not to overstrain the new kidney.
You can do that yourself
In the case of nephropathy caused by high blood pressure, the patient himself can do a great deal to improve his condition.
If the person concerned has been prescribed antihypertensive drugs, then it is of the utmost importance that these are taken regularly and exactly as prescribed. In addition, it is usually necessary for patients to make lifestyle changes to reduce the risk of high blood pressure. Patients with a BMI of 25 or higher urgently need to reduce their weight. If this is not possible on your own, a nutritionist or a nutritionist should be consulted. Some of those affected also benefit from self-help groups that exist in all major cities. In addition, there are now numerous offers of help for overweight people on the Internet.
Regular physical exercise is also of central importance. On the one hand, exercise helps patients to lose weight and not gain it again. In addition, endurance sports in particular also have a directly beneficial effect on blood pressure. We recommend four to five training sessions per week with a duration of at least 30 minutes. In addition to the sports of cycling and swimming, brisk walks and regular climbing of stairs are particularly suitable. Strength exercises should be avoided in the gym and endurance trained instead. Alcohol and cigarettes are counterproductive.