What should I do about hypertension caused by kidney disease?
Aug 04, 2022
Source: Cainiu Health
Dr. Zhang Jianbin
Introduction
Renal hypertension can be treated under a physician’s guidance with antihypertensive medications, diuretics, and agents that protect renal function. Also known as renovascular hypertension, renal hypertension arises from pathological changes in the glomeruli, renal tubules, and small renal arteries. One underlying mechanism involves impaired renal excretion of water and sodium, leading to water and sodium retention and consequently volume-dependent hypertension.
Hypertension is a common cardiovascular and cerebrovascular disease encountered in daily life, predominantly affecting middle-aged and elderly individuals. When diagnosed with hypertension, prompt medical consultation and treatment are essential to prevent disease progression and safeguard overall health. Untreated or poorly controlled hypertension may lead to severe complications, such as hypertensive nephropathy. So, what should be done when hypertension coexists with kidney disease?
Management of Hypertension Associated with Kidney Disease
Hypertension secondary to kidney disease—also termed “renovascular” or “renal hypertension”—can be managed under physician supervision using antihypertensive medications (e.g., vasodilators and angiotensin antagonists), diuretics, and renoprotective agents. This form of hypertension arises from pathological changes in the glomeruli, renal tubules, and small renal arteries. Its pathophysiology involves two primary mechanisms: first, impaired renal excretion of water and sodium leads to fluid and sodium retention, resulting in volume-dependent hypertension; second, excessive renin secretion by the kidneys causes vasoconstriction of small arterioles, leading to renin-dependent hypertension. Therefore, effective treatment requires not only antihypertensive drugs—such as valsartan and nifedipine—that promote vasodilation and block the renin-angiotensin system, but also diuretics to alleviate fluid and sodium retention.
Hypertension associated with kidney disease encompasses two main subtypes: renal parenchymal hypertension and renovascular hypertension. Renal parenchymal hypertension results from intrinsic kidney diseases—including chronic glomerulonephritis, membranous nephropathy, and lupus nephritis—that progressively elevate blood pressure. These conditions are particularly detrimental, as rising blood pressure further damages renal parenchyma, thereby establishing a vicious cycle of worsening hypertension and renal injury.
Patients are advised to adopt healthy lifestyle habits, especially regarding diet—avoiding spicy and irritating foods. We hope this information proves helpful to you.
