Hypertension-Induced Chronic Kidney Disease

The only way to diagnose hypertension is to have it measured repeatedly over several times of the day and several days. This is because hypertension does not give rise to any symptoms. Rarely, it can cause headaches.

You can have your blood pressure measured at a doctor’s office, or you can keep a digital blood pressure monitor to check by yourself at home. 

Early chronic kidney disease (CKD) also may not have symptoms. As the disease progresses, the following signs and symptoms develop:

• Edema (swelling) over the ankle, feet, or legs
• Loss of appetite
• Nausea
• Vomiting
• Drowsiness
• Fatigue
• Disturbed sleep
• Headaches
• Trouble concentrating
• Frequent urination or decreased urination
• Nocturia (frequent trips to the washroom at night)
• Hematuria (blood in the urine)
• Itching all over the body
• Dry skin or darkened skin
• Weight loss
• Muscle cramps
• Shortness of breath

Anyone who has high blood pressure is more likely to develop chronic kidney disease (CKD) in the absence of treatment.

Your doctor will take your complete medical history and perform a physical examination. If you have uncontrolled hypertension (and some symptoms that point toward a kidney problem), they may order the following tests to diagnose if you have hypertension-induced CKD:

• Kidney function tests: This test will look at your creatinine levels to check if you have trouble with your kidneys.
• Blood tests: Low hemoglobin levels are found in CKD.
• Urine test: This will be done particularly to check for the presence of protein. Proteinuria (persistent protein) in the urine is a sign of kidney damage. Other things that the doctor will look for include red blood cells (RBCs) and white blood cells (WBCs).
• Glomerular filtration rate (GFR): It is a measure to estimate the level of kidney function. It is calculated by a lab specialist based on a combination of several factors that include your creatinine levels, age, weight, height, etc. GFR test is usually done after the above tests show abnormalities. Doctors usually confirm kidney damage on encountering low levels of GFR.
• Ultrasonography (USG) of the pelvis: The doctor may order this imaging test to know if there are any structural problems in the kidneys.

Your doctor would also like to know if you have diabetes or heart problems. Hence, they may ask for the following tests:

• Blood sugar test
• Urine sugar test
• Electrocardiography (ECG)

There is no cure for hypertension-induced chronic kidney disease (CKD). Treatment can just help to control the signs and symptoms. Your doctor may refer you to a kidney specialist (nephrologist) to treat your hypertension-induced CKD. The prescribed medications will aim at

• lowering your blood pressure to less than 130/80 mm Hg,
• halting the worsening of the kidney disease, and
• reducing your risks of heart disease.

Advanced stages of CKD usually require lifetime dialysis or a kidney transplant to increase survival by a few years.

Along with the right medications, certain lifestyle changes are a must. The dietary modification depends on the stage of CKD you are at. For example, higher stages of CKD demand low intakes of protein, phosphorus, and potassium. A certified nutritionist can chalk out a diet plan that will work best for you.

Here are some commonly recommended lifestyle steps:

• Exercising for at least 30 minutes a day or 150 minutes in a week
• Having a salt-restricted (low in sodium) diet
• Eating lots of fruits and vegetables (after medical advice only)
• Managing stress through activities such as yoga and deep breathing

Hypertension-induced chronic kidney disease (CKD) carries several risks:

• Excessive fluid retention in many parts of the body
• Anemia (low blood hemoglobin levels)
• Hyperkalemia (high blood potassium levels that can damage the heart)
• Cardiovascular disease (heart and blood vessel disease)
• Insomnia (difficulty falling asleep or staying asleep)
• Lower sex drive
• Erectile dysfunction
• Osteomalacia (weakening of the bones)
• Damage to the central nervous system
• Weak immune system