Do you have hypertension? Your kidneys might be at risk!

Updated: April 6, 2020 6:09:42 PM

One remarkable fact is that the majority of the patients are symptom-less, so the opportunity of early intervention by Lifestyle modification or by medicines has been missed.

Keywords: hypertension, lifestyle, kidney, high blood pressure, end stage kidney failure, heart attack, kidney failure, glomerulosclerosis, Chronic kidney diseaseThe kidney is both a cause and a victim of hypertension

By  Dr Tejendra Singh Chauhan

In the last few decades, hypertension has emerged as a principal cause of major health problems worldwide. Major causes of death and disability like cardiovascular disease (heart attack and heart failure), kidney failure, and stroke have hypertension as one of the major root causes. The prevalence of hypertension has increased worldwide and in India also. In a recent big Indian Survey, District Level Health Survey( DLHS4 )has reported hypertension in 25.3 % adults in India with a greater prevalence in men as compared to women and narrow urban rural differences. In this survey hypertension is defined as BP = 140 and/or = 90 mmHg and this percentage would translate into 20.7 crores persons with hypertension in our country.

One remarkable fact is that the majority of the patients are symptom-less, so the opportunity of early intervention by Lifestyle modification or by medicines has been missed.

The kidney is both a cause and a victim of hypertension

High blood pressure is a key factor that contributes to the deterioration of kidney function. Vise versa, the presence of kidney disease is a common and underappreciated medical cause of difficulty to treat hypertension as well.

Worldwide hypertension is the leading cause of End Stage Kidney Failure (which requires hemodialysis or kidney transplantation for survival). It has been scientifically proven that sustained hypertension is indeed a significant contributor to the progression of kidney failure. It is believed that high blood pressure transmits into delicate and fragile small blood vessels of kidneys (glomerular capillary bed) which results in their damage and scarring (glomerulosclerosis) which clinically presents as progressive renal failure.

Similar to hypertension, early kidney damage is entirely symptomless, and this is the reason that 50 % of patients with advanced kidney failure are seen when 90 % of kidney functions are gone. The reported prevalence of Chronic kidney disease (CKD) in different regions of India ranges from ,1% to 13%, and recently, data from the International Society of Nephrology’s Kidney Disease Data Center Study reported a prevalence of 17%,which means every sixth person in India has some form of kidney disease. There are over 130,000 patients receiving dialysis, and the number is increasing by about 232 per million population i.e. around 2.5 lakh new patients per year.

Over 90% of End Stage Kidney Failure (ESRD) patients in India die because of inability to afford care, and even in those who do start such treatment, 60% stop for financial reasons. So the need of hour is to diagnose and treat kidney diseases at an early stage.

How does one recognize the presence of kidney disease?

If you are hypertensive you should screen yourself for kidney disease. Two simple test creatinine levels in blood and presence of protein in urine can diagnose the majority of kidney diseases. In spite of these laboratory updates, recent data show that a given patient’s knowledge that he or she has Chronic Kidney Disease (CKD) is very low.

What can be done about this problem?

Early detection of kidney failure in hypertensive populations is the first step. It has been proved that a blood pressure target of less than 130/80 is required to prevent progressive kidney damage. So every effort should be made to maintain this level. Lifestyle modifications like low salt diet, avoidance of junk food, regular exercises, and loss of excess weight help in blood pressure control and protection of kidneys as well.

How to protect our kidneys?

Early detection of kidney disease is the key . If you are above 40 or have a high risk of kidney disease like hypertension, diabetes, kidney stone disease, or family history of kidney ailment, you should check your kidneys. Detection of kidney failure also warranted in those having symptoms of kidney disease like body swelling, unexplained weight loss, lack of appetite, uncontrolled blood pressure and any form of urinary complaints. Good sugar control in diabetes, stone management and diet restriction in kidney stone disease and maintaining a healthy lifestyle in general can prevent us from kidney diseases.

The author is HOD & Sr. Consultant-Nephrology, Fortis Escorts Hospital, Faridabad. Views expressed are the author’s own.

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