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Hypertension is the second leading cause of chronic kidney failure


Excessive blood pressure often results in chronic kidney failure

Kidney disease is often due to high blood pressure. This is the second most common cause of severe kidney disease after diabetes, according to the German Hypertension League in a recent announcement on March 8th. Chronic kidney damage can often be avoided through timely and consistent treatment of high blood pressure.

If the blood pressure is too high, the kidneys are permanently affected and can only function to a limited extent. The result is chronic kidney failure. The nephrological specialist associations estimate that such chronic kidney failure in Germany can be attributed to 24 percent to high blood pressure, according to the German Hypertension League. Early therapy can prevent many of these kidney diseases.

Kidneys perform at their best every day

The kidneys have to perform at their best every day. "The blood in the kidneys is filtered and freed of pollutants about 300 times a day," reports the German High Pressure League. This work is done in each kidney by about a million microscopic kidney bodies connected to a tubule in which the urine is produced. In their entirety, these units are called nephrons. According to the experts, they can be damaged by high blood pressure.

Critical loss of kidney corpuscles

"Even healthy people lose nephrons in the course of their lives," explains the CEO of the German Hypertension League, Professor Dr. med. Bernhard Krämer, director of the V. Medical Clinic at the University Medical Center Mannheim. However, the destruction of the kidney corpuscles is accelerated in people with high blood pressure, "so that in the end there are no longer enough nephrons to rid the blood of metabolic waste."

Many dialysis cases can be attributed to high blood pressure

Around 20 to 30 million people in Germany who suffer from high blood pressure are at the same time exposed to an increased risk of kidney disease. Almost a quarter of cases of chronic kidney failure are due to high blood pressure, according to the high-pressure league, and "high blood pressure in Germany would be responsible for 20,000 of over 80,000 dialysis cases," emphasizes Professor Krämer. However, many diseases can be avoided by timely and good treatment of high blood pressure.

What therapeutic options are there?

"Not only do we have a number of medications that lower blood pressure and thus protect the kidneys", but "some drugs such as ACE inhibitors or AT1 antagonists can also reduce blood pressure by inhibiting angiotensin II, and often in kidney diseases prevent further deterioration of kidney function, ”explains Prof. Bernhard Krämer. Given the relationship between blood pressure and kidneys, the experts also advise all patients with high blood pressure to have their kidney function checked regularly.

Kidneys can also be the cause of high blood pressure

The kidney function is checked by examining the urine for albumin, which is increasingly excreted in many kidney diseases. A 24-hour blood pressure measurement provides first indications as to whether the high blood pressure is caused by the kidneys. Because there is also a connection in this direction. For example, high blood pressure can develop if there is a narrowing of the renal arteries. If the kidneys are the cause of high blood pressure, "the slight drop in blood pressure that occurs in the late hours is often missing," explains Professor Dr. Ulrich Wenzel from the University Medical Center Hamburg-Eppendorf.

How can kidney-related hypertension be treated?

According to the experts, ultrasound and laboratory examinations can usually determine to what extent the kidneys are the cause of increased blood pressure. In addition, "if the renal arteries are narrowed, angiography with dilation and stent insertion can improve blood pressure and kidney function in selected cases," reports the German Hypertension League. In patients whose blood pressure can definitely not be reduced by medication, the obliteration of nerve fibers in the renal arteries can be considered to lower the blood pressure. According to Professor Wenzel, however, this is currently only used in special exceptional cases and in the context of clinical studies.

According to the German Hypertension League, kidney-related hypertension can also be alleviated by a healthy lifestyle. Important factors here are:

  • Refrain from smoking as this prevents premature calcification of the renal arteries.
  • A low-salt diet, because it relieves the kidneys, which are also responsible for the excretion of excess salt from the diet.

In addition, existing hypertension can be alleviated naturally through stress relief and a healthy diet, although the negative effects of excessive salt consumption cannot be compensated for. In any case, this should be reduced to the lowest possible level (maximum 6 grams per day for adults; DGE recommendation). (fp)

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Video: High Blood Pressure and Your Kidneys - A to Z Guide (August 2020).