Most people with high blood pressure (hypertension) have no symptoms. The only way to know whether a person's blood pressure is high is to have a health professional measure it with a blood pressure cuff. The result is expressed as two numbers. The top number, called the
systolic pressure, represents the pressure when the heart is beating. The bottom number, called the
diastolic pressure, shows the pressure when the heart is resting between beats.
A person's blood pressure is considered normal if it stays at or below 120/80, which is commonly stated as "120 over 80." People with a systolic blood pressure of 120 to 139 or a diastolic blood pressure of 80 to 89 are considered prehypertensive and should adopt lifestyle changes to lower their blood pressure and prevent heart and blood vessel diseases. A person whose systolic blood pressure is consistently 140 or higher or whose diastolic pressure is 90 or higher is considered to have high blood pressure and should talk with a doctor about the best ways to lower it.
Introduction to high blood pressure and kidney disease
The kidneys play a key role in keeping a person's blood pressure in a healthy range, and blood pressure, in turn, can affect the health of the kidneys.
High blood pressure, also called hypertension, can damage the kidneys and lead to chronic kidney disease (CKD).
What is high blood pressure?
Blood pressure measures the force of blood against the walls of the blood vessels. Extra fluid in the body increases the amount of fluid in blood vessels and makes blood pressure higher. Narrow, stiff, or clogged blood vessels also raise blood pressure.
Hypertension can result from too much fluid in normal blood vessels or from normal fluid in narrow, stiff, or clogged blood vessels.
People with high blood pressure should see their doctor regularly.
How does high blood pressure hurt the kidneys?
High blood pressure makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. The extra fluid in the blood vessels may then raise blood pressure even more. It's a dangerous cycle.
High blood pressure is one of the leading causes of
kidney failure, also called end-stage renal disease (ESRD). People with kidney failure must either receive a kidney transplant or have regular blood-cleansing treatments called dialysis. Every year, high blood pressure causes more than 25,000 new cases of kidney failure in the United States.1
1United States Renal Data System. USRDS 2007 Annual Data Report. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services; 2007.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
Hyperkalemia is an abnormally high level of potassium in the blood. Symptoms of hyperkalemia include nausea, fatigue, tingling sensations, or muscle weakness. Hyperkalemia may also cause no symptoms. Slow heartbeat and weak pulse are more serious symptoms. Causes of hyperkalemia include kidney dysfunction, medications, adrenal gland diseases, and potassium shifts. Treatment of hyperkalemia is dependant upon the cause.
Henoch-Schonlein Purpura (HSP or anaphylactoid purpura), a type of blood vessel inflammation, results in rash, arthritis, and occasional abdominal cramping. HSP often resolves on its own. Joint pain may be treated with anti-inflammatory and cortisone medications.
Pulmonary edema (swelling or fluid in the lungs) can either be caused by cardiogenic causes (congestive heart failure, heart attacks, abnormal heart valves) or noncardiogenic causes such as ARDS, kidney failure, high altitude, pneumothorax, pleural effusion, aspirin overdose, pulmonary embolism, and infections. The treatment of pulmonary edema depends on the cause of the condition.
Renal artery stenosis is a narrowing of the diameter of the renal arteries. When the renal arteries narrow, the result is restricted blood flow to the kidneys, which may lead to impaired kidney function and high blood pressure (referred to as renovascular hypertension (RVHT). Renal artery stenosis can occur in one or both kidneys. The primary cause of renal artery stenosis is atherosclerosis. Risk factors for renal artery stenosis include high blood pressure, high cholesterol levels, age, cigarette smoking, and diabetes. Symptoms of renal artery stenosis include high blood pressure that does not respond to treatment, severe high blood pressure in individuals younger than 30 or greater than 50 years of age. Renal artery stenosis is diagnosed with imaging and functional tests. Treatment for renal artery stenosis include medication or surgery.
Polycystic kidney disease (PKD) is characterized by numerous cysts in the kidneys. Polycystic kidney disease is a genetic disorder. There are two major inherited forms of PKD, autosomal dominant PKD, and autosomal recessive PKD. Symptoms include headaches, urinary tract infections, blood in the urine, liver and pancreatic cysts, abnormal heart valves, high blood pressure, kidney stones, aneurysms, and diverticulosis. Diagnosis of PKD is generally with ultrasound, CT or MRI scan. There is no cure for PKD, so treatment of symptoms is usually the general protocol.
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
Hyperkalemia is common; it is diagnosed in up to 8% of
hospitalized patients in the U.S. Fortunately, most patients have mild
hyperkalemia (which is usually well tolerated). However, any
condition causing even mild
hyperkalemia should be treated to prevent progression into more severe
hyperkalemia. Extremely high levels of potassium in the blood (severe
hyperkalemia) can lead to cardiac arrest and
death. When not recognized and treated properly, severe hyperkalemia results in
a mortality rate of about 67%.
Technically, hyperkalemia means an abnormally elevated level of potassium in the blood.
The normal potassium level in the blood is 3.5-5.0 milliequivalents per liter
(mEq/L). Potassium levels between 5.1 mEq/L to 6.0 mEq/L reflect mild hyperkalemia.
Potassium levels of 6.1 mEq/L to 7.0 mEq/L are moderate hyperkalemia, and levels
above 7 mEq/L are severe hyperkalemia.
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