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Article title: High Blood Pressure and Kidney Disease: NIDDK
Your kidneys play a key role in keeping your blood pressure in a healthy range, and blood pressure, in turn, can affect the health of your kidneys. High blood pressure, also called hypertension, can damage the kidneys.
Hypertension can result from too much fluid in normal blood vessels or from normal fluid in narrow blood vessels.
Blood pressure measures the force of blood against the walls of your blood vessels. Blood pressure that remains high over time is called hypertension. Extra fluid in your body increases the amount of fluid in your blood vessels and makes your blood pressure higher. Narrow or clogged blood vessels also raise blood pressure.
If you have high blood pressure, see your doctor regularly.
High blood pressure makes your heart work harder and, over time, can damage blood vessels throughout your body. If the blood vessels in your kidneys are damaged, they may stop removing wastes and extra fluid from your body. The extra fluid in your 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 commonly called end-stage renal disease (ESRD). People with kidney failure must either receive a kidney transplant or go on dialysis. Every year, high blood pressure causes more than 15,000 new cases of kidney failure in the United States.
Most people with high blood pressure have no symptoms. The only way to know whether your blood pressure is high is to have a health professional measure it. The result is expressed as two numbers. The top number, which is called the systolic pressure, represents the pressure when your heart is beating. The bottom number, which is called the diastolic pressure, shows the pressure when your heart is resting between beats. Your blood pressure is considered normal if it stays below 130/85 (expressed as "130 over 85"), but recent studies suggest that people with kidney disease should keep their blood pressure even lower.
Kidney damage, like hypertension, can be unnoticeable, detected only through medical tests. Blood tests will show whether your kidneys are removing wastes efficiently. Your doctor may refer to tests for serum creatinine and BUN, which stands for blood urea nitrogen. Having too much creatinine and urea nitrogen in your blood is a sign that you have kidney damage.
Another sign is proteinuria, or protein in your urine. Proteinuria has also been shown to be associated with heart disease and damaged blood vessels. (For more information, see the NIDDK fact sheet on proteinuria.)
If you have kidney damage, you should keep your blood pressure well below 130/85. The National Heart, Lung, and Blood Institute (NHLBI), one of the National Institutes of Health (NIH), recommends that people with kidney disease use whatever therapy is necessary, including lifestyle changes and medicines, to keep their blood pressure at or below 130/85, or even below 125/75 when protein in the urine exceeds 1 gram per 24 hours.
How can I control my blood pressure?NHLBI has found that five lifestyle changes can help control blood pressure:
Many people need medicine to control high blood pressure. A group of medications called ACE (angiotensin-converting enzyme) inhibitors lower blood pressure and have an added protective effect on the kidney in people with diabetes. Additional studies have shown that ACE inhibitors also reduce proteinuria and slow the progression of kidney damage in people who do not have diabetes. You may need to take a combination of two or more blood pressure medicines to reach 125/75.
All racial groups have some risk of developing kidney failure from high blood pressure. African Americans, American Indians, and Alaska Natives, however, are more likely than whites to have high blood pressure and to develop kidney problems from it--even when their blood pressure is only mildly elevated. In fact, African Americans ages 25 to 44 are 20 times more likely than whites in the same age group to develop hypertension-related kidney failure.
People with diabetes also have a substantially increased risk for developing kidney failure. People who are at risk both because of their race and because of diabetes should have early management of high blood pressure.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), also part of NIH, is sponsoring a study to find effective ways to prevent high blood pressure and kidney failure in African Americans.
In recent years, researchers have learned a great deal about kidney disease. NIDDK sponsors several programs aimed at understanding kidney failure and finding treatments to stop its progression.
NIDDK's Division of Kidney, Urologic, and Hematologic Diseases supports basic research into normal kidney function and the diseases that impair normal function at the cellular and molecular levels, including diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease.
American Kidney Fund
6110 Executive Boulevard, Suite 1010
Rockville, MD 20852
Phone: 1-800-638-8299 or (301) 881-3052
National Heart, Lung, and Blood Institute Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Phone: (301) 592-8573
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
Phone: 1-800-622-9010 or (212) 889-2210
3 Information Way
Bethesda, MD 20892-3580
The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1987, the clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.
Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This fact sheet was reviewed by Vito M. Campese, M.D., University of Southern California, and Matthew Weir, M.D., University of Maryland.
This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.
NIH Publication No. 01-4572
Posted: August 2001
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