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Hypertension & Chronic Kidney Disease

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Explore helpful information related to this common cause of CKD

According to the National Kidney Foundation, high blood pressure is the second most common cause of chronic kidney disease1. It also increases the chances that kidney disease will get worse. That’s why it’s important to:

  • Understand the connection between hypertension and chronic kidney disease.
  • Keep your blood pressure under control. This means taking all your blood pressure pills as prescribed, and checking your blood pressure.
  • Follow a healthy diet and exercise regularly.
  • Get tests that check kidney function.
  • Follow the prescribed treatment plan from your doctor, which may help preserve kidney function for as long as possible.

Know your GFR flow
Glomerular filtration rate (GFR) is a measure of how well your kidneys are working. It helps your doctor diagnose kidney disease by determining how well your kidneys are cleaning your blood.

Learn about diagnosis

High Blood Pressure and CKD

HypertentionHigh blood pressure is a leading cause of chronic kidney disease. Because kidneys help regulate blood pressure, high blood pressure can also be caused by chronic kidney disease. It’s a challenging cycle that needs careful monitoring and management.

Blood pressure should be managed to less than 130/80 if you have chronic kidney disease.2

According to the National Kidney Foundation, if you have high blood pressure your doctor can conduct the following tests to help determine if you also have kidney disease.2

  • GFR (glomerular filtration rate) is a measure of how well your kidneys are working and  helps your doctor determine how well your kidneys are cleaning your blood.
  • A urine test to measure protein levels and red and white blood cells.
  • Ultrasound to check your kidneys. This can help determine what kind of chronic kidney disease you may have.

You may also have tests to find out if you are at risk to develop heart and blood vessel diseases. These can include:2

  • An electrocardiogram (EKG).
  • A blood test for glucose (sugar).
  • A blood test for fatty substances in your blood, called lipids. Cholesterol is an example of a lipid.
  • Your height and weight measurements. This determines your body mass index, or BMI, which is a way to tell if you are overweight.

According to the National Kidney Foundation, your doctor will also:

  • Monitor your potassium levels. Potassium may build up to high levels as your kidney function decreases. This is especially dangerous for your heart. There are certain blood pressure medications that can also cause high potassium levels.
  • Develop a treatment plan to help you manage your high blood pressure and chronic kidney disease. If you have chronic kidney disease and high blood pressure, your doctor may recommend a special diet for you based on your stage of chronic kidney disease.
  • Need to know all the medicines you take. There may be some medications you need to limit or avoid, including some over-the-counter (non-prescription) medications. 

 Talk to your doctor about your treatment plan and follow it as directed.

Anyone can get high blood pressure, but there are factors that increase the risk for it. Some factors include:

Your age The tendency to develop high blood pressure increases as you age
Your family history High blood pressure tends to run in families
Your lifestyle Your lifestyle can raise your blood pressure.
  • Being overweight or obese
  • Not being physically activity
  • Having a poor diet, especially high in salt (sodium)
  • Drinking too much alcohol

Each are risk factors for high blood pressure.

Gender Men are more likely to have high blood pressure at a young age (under 45). After age 65, women are more likely than men to have high blood pressure.

Is your blood pressure high?

The National Kidney Foundation confirms the only way to tell if your blood pressure is too high is to have it measured. High blood pressure usually doesn’t cause symptoms. A single high reading does not mean you have high blood pressure. It can be confirmed by follow-up visits to your doctor.2

Reading blood pressure measurements

Blood pressure is measured as two numbers. For instance 130/80 (130 over 80):

  • 130 represents systolic blood pressure number. This top number measures the pressure when your heart is beating.
  • 80 represents diastolic blood pressure. This bottom number measures the pressure when your heart is resting.

Normal blood pressure For adults 18 and older less than 120/80
More likely to develop high blood pressure Top number between 120 and 139
Bottom number between 80 and 89
High blood pressure Blood pressure that stays at 140/90 or higher
High blood pressure with chronic kidney disease Blood pressure that is 130/80 or higher2

Checking blood pressure

As the National Kidney Foundation describes, blood pressure is usually checked by using a blood pressure cuff around your upper arm. It should be checked every time you visit a doctor or clinic. Some people with high blood pressure are taught how to check at home.

Keeping a record of your daily blood pressure can help you and doctor monitor your control and make good treatment decisions.

Ask your doctor to have the following tests to monitor possible chronic kidney disease:2

  • A blood test to measure GFR (glomerular filtration rate) to determine how well your kidneys are working.
  • A urine test to measure protein levels, and to check red and white blood cell levels. 
If you have high blood pressure, it’s important to follow your treatment plan. A treatment plan should include monitoring for chronic kidney disease. The National Kidney Foundation says the goals of your plan are to:2
  • Lower your blood pressure to less than 130/80
  • Lower your chance of getting heart disease
  • Keep your kidney disease from getting worse

Following your chronic kidney disease treatment plan can help you care for your kidneys and control your blood pressure. It should be based your stage of chronic kidney disease. In some cases, your doctor may recommend that you see a doctor with special training in kidney disease (called a nephrologist) or high blood pressure. The nephrologist will help develop your treatment plan.

Making changes to your diet and lifestyle

According to the National Kidney Foundation, if you have chronic kidney disease and high blood pressure your doctor may recommend you follow a diet that limits certain foods or additives, such as:2

  • Salt (sodium).
  • Foods high in saturated fats and cholesterol.
  • Carbohydrates (found in many foods, such as bread, rolls, rice, pasta, potatoes, dried beans, fruits and juices, and milk and yogurt).

If you are in the later stages of chronic kidney disease (stages 3-4), you may be asked to make additional changes. You may need to limit:2

  • The amount of protein you eat.
  • Foods that contain phosphorus which can lead to weak, brittle bones, and can lead to hardened blood vessels that can harm your heart.
  • Foods that contain potassium, which can build up to unsafe levels as kidney function decreases. This can then be dangerous for your heart.

Other lifestyle changes that can help you stay healthy:

  • Exercise regularly.
  • Maintain a healthy body weight.
  • Manage stress.
  • Limit alcohol intake.
  • Avoid smoking tobacco products (should be avoided for a variety of health reasons). 

Take your blood pressure medications

There are many medications that can be used to treat high blood pressure. It's important to know:

  • What medicine(s) you are taking.
  • How they work.
  • How to take them as directed.
  • The National Kidney Foundation includes the following as possible medications:

  • An angiotensin converting enzyme (ACE) inhibitor.
  • An angiotensin receptor blocker (ARB).
  • A diuretic or water pill.
  • Other medications, such as beta blockers or calcium channel blockers.

Always take your medications as directed by your doctor. Report and side effects to your doctor right away.

Know what medicine to limit or avoid

If you are taking blood pressure medication, you may have to limit or avoid some over-the-counter (non-prescription) medications. Some of these medications can raise blood pressure or interfere with your blood pressure medication.

Talk to your doctor about:

  • Cough and cold medicines.
  • Pain medications such as ibuprofen.
  • Herbal remedies or nutritional supplements.
  • Any new medication you are prescribed (no matter what it is).

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