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Hypertension and kidney disease are two closely linked disease states, prolonged hypertension can lead to impaired kidney function and deterioration of kidney function can lead to blood pressure control. pressure worsens.
1. What is kidney disease?
Here refers to chronic kidney disease, which is a condition in which the kidneys are damaged by other diseases, such as diabetes, high blood pressure, glomerulonephritis, that make the kidneys unable to perform their functions properly. :
Remove waste, excess fluid from the body Release hormones that help control blood pressure, promote strong bones, prevent anemia by increasing the number of red blood cells in the body. Maintain electrolyte balance Maintain acid and base balance in the body When your kidneys aren't working properly, waste products can build up in high levels in your blood and make you feel tired. Even before that, patients with kidney disease can develop complications such as high blood pressure, anemia, weak bones, poor nutritional health, and nerve damage. Kidney disease also makes you more susceptible to heart and blood vessel disease. These problems can come on slowly, over a long period of time, often without symptoms. Chronic kidney disease can eventually lead to kidney failure requiring dialysis or a kidney transplant to sustain life. Early detection and treatment can prevent or delay these complications.
Bệnh thận xảy ra khi thận hoạt động không tốt
2. What is hypertension?
Blood pressure is the force of blood against the walls of blood vessels as the heart pumps blood around the body. If this pressure is higher than normal, it is called hypertension or high blood pressure.
High blood pressure is one of the leading causes of kidney disease. Over time, high blood pressure damages blood vessels throughout the body, which can reduce blood supply to vital organs like the kidneys. High blood pressure also damages the glomerular filtration units, making it impossible for the kidneys to filter waste and excess fluid out of the body, which builds up in the blood vessels and causes high blood pressure. more severe pressure.
High blood pressure is also a complication of kidney disease. The kidneys play an important role in stabilizing blood pressure. Damaged kidneys will reduce the ability to regulate blood pressure, leading to increased blood pressure.
3. Why is blood pressure high with kidney disease?
The pathophysiology of hypertension in patients with renal disease is complex and a sequelae of many factors, including decreased nephron mass, increased sodium retention and extracellular volume expansion, and overactivity of nephrons. sympathetic nervous system, which activates hormones including the renin-angiotensin-aldosterone system. The mechanisms involved in the development of hypertension in patients with renal disease include:
Renal disease is associated with increased activity of the RAA (renin-angiotensin-aldosterone) system. There is a decrease in blood flow in the peritoneal capillaries downstream of the sclerotic glomerulus. The result of decreased blood flow is that the glomeruli increase renin, thereby increasing the level of circulating angiotensin II. Angiotensin II has a direct vasoconstrictor effect, increasing systemic vascular resistance. Because there are few functioning glomeruli in CKD, each remaining glomerulus must increase its glomerular filtration rate (GFR): increasing systemic arterial pressure helps increase perfusion pressure. Angiotensin II also promotes sodium reabsorption in the proximal tubule and (via aldosterone) the collecting duct. Furthermore, a decrease in overall glomerular filtration rate reduces sodium excretion, which also leads to sodium retention. Sodium retention induces hypertension through volume-dependent and volume-independent mechanisms. Excessive extracellular volume leads to increased perfusion of peripheral tissues, stimulation of vasoconstriction, increased peripheral vascular resistance, and thus increased blood pressure. CNS overactivity in chronic kidney disease stimulates renin production by paraglomerular cells. In addition to CNS activation by sodium retention, renal ischemia also leads to renal nerve stimulation via adenosine. Finally, experimental and clinical studies suggest that angiotensin II levels (which are higher in patients with kidney disease) directly stimulate central nervous system activity. Endothelial dysfunction is also implicated in the pathophysiology of hypertension in patients with chronic kidney disease. Several factors associated with kidney disease complications may also contribute to the high prevalence of hypertension in patients with kidney disease.
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4. How to recognize high blood pressure?
The only way to know if your blood pressure is too high is to measure it. High blood pressure usually causes no symptoms. That's why it's called the "silent killer". One blood pressure reading does not mean you have high blood pressure. It needs to be confirmed during follow-up visits with the doctor. Blood pressure is measured in two numbers. The number above, or systolic pressure, is the pressure when your heart contracts. The bottom number, or diastolic pressure, is the pressure when your heart is resting between contractions. Normal blood pressure in adults 18 years of age and older is less than 120/80. People with systolic blood pressure between 120 and 139, or diastolic blood pressure between 80 and 89, may be more likely to have high blood pressure. In general, a blood pressure of 140/90 or higher is considered high blood pressure. However, for people with diabetes or kidney disease, a blood pressure of 130/80 or higher is considered high blood pressure.
5. How is high blood pressure and kidney disease treated?
The treatment plan depends on the stage of the kidney disease. The treatment goals for patients with kidney disease with hypertension are:
Reduce blood pressure to less than 130/80 Prevent kidney disease from worsening Reduce the risk of heart disease. To help achieve these goals, you'll need a treatment regimen that includes lifestyle changes, such as a healthier diet and more exercise, combined with medication.
Vinmec International General Hospital with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in medical examination and treatment, patients can rest assured to visit. examination and treatment at the Hospital.
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
