High blood pressure leads to kidney damage

MANILA, Philippines - Control your blood pressure and save your kidneys. This was the message of health experts during the recent celebration of World Kidney Day. With more people succumbing to kidney failure and chronic kidney disease (CKD) worldwide, knowing that high blood pressure destroys the kidneys is important. Concomitantly, an increased vigilance to keep blood pressure within normal parameters will result in lessening the incidence of cardiovascular disease, stroke or debilitating kidney damage. In turn, this will lead to better health and longer, more productive lives.

“In the Philippines, renal disease is the number 10 cause of death today,” says Dr. Enrique Ona, executive director of the National Kidney and Transplant Institute. He estimates that 100 to 120 individuals per population of one million develop end-stage renal failure. “This is the most expensive disease that one can encounter,” he continues.

 The kidney is a non-regenerating organ, therefore making damage permanent. Since the disease is chronic, dialysis is expensive and a compatible kidney donor may be difficult to find, the resources that an average patient can spend for maintenance will likely run out. Without proper treatment, the toxins will accumulate in the body and eventually poison the patient.   

Are your kidneys at risk? Apart from hypertension and cardiovascular disease, another factor that can significantly affect the kidneys is diabetes mellitus and poor blood sugar level control. Smoking, being overweight, and a family history of kidney disease can tip the scales against you. Although age (over 50 years) also predisposes one to the disease, even the young can succumb to CKD.

Nephrologist Dr. Agnes Mejia, chairman of the Department of Medicine at the University of the Philippines- Philippine General Hospital, cited the case of a 22-year-old engineering student. Complaining of poor appetite, headache, weakness, pruritus (itching), weight loss, shortness of breath, and easy fatigability, he was admitted to the hospital for evaluation and was found to have end-stage kidney disease. A medical history showed that he suffered from bouts of urinary tract infection (UTI) in previous years. He should have taken heed.

“As a rule, men should not have UTI,” says Dr. Mejia. The frequency of the urinary tract infections should have alerted health providers about the possibility of a more serious underlying condition. His blood pressure was also elevated and when admitted to the hospital, the young man had a distinctive ammonia-like or fishy breath odor, a symptom associated with chronic kidney or renal failure. As is the case with most patients with severe renal failure, the story ended unhappily. The patient passed away during what should have been the prime of his life.

  What are the symptoms to watch out for?

Dr. Mejia says one should be wary when urine is cloudy or bubbly — “beer urine with bubbles on top.” Nocturia or frequent urination at night and swelling of the legs (edema) without pain should also serve as warning signs. To be even more certain, blood pressure should be monitored so that it does not exceed 130/80 mm Hg. In addition, blood creatinine levels should be checked. Since creatinine or the breakdown product of creatine phosphate in muscle is filtered out of the blood by the kidneys, increased levels will signal that the kidney is not working effectively. The link between high blood pressure and CKD is unmistakable so that nephrologists worldwide seek to heighten awareness to make blood pressure measurement and examination of urine routine.

“High blood pressure is a global problem and the situation is projected to get worse. The world population is getting older and aging is the common risk factor for the development of high blood pressure and diabetes as well as CKD,” reiterates a fact sheet from the International Society of Nephrology and the International Federation of Kidney Foundations.

Although more innovative and effective medications to control blood pressure and its attendant complications are being introduced to the market, it is best to avoid illness with healthy lifestyle choices.

Consider these facts and act accordingly: Weight loss of eight to 10 pounds can have a dramatic impact on blood pressure. Reducing alcohol consumption leads to decreased blood pressure. Lowering blood cholesterol prevents narrowing of blood vessels, which is another cause of blood pressure rise. Other key preventive measures are control of glucose (in diabetics) and anemia, smoking cessation, and increased activity.

Disease wreaks havoc on the individual’s body, possibly causing extreme pain and discomfort. The costs of treatment for CKD can financially burden a family. The consequences of increased prevalence burden healthcare systems and society. Undoubtedly, the best way to beat and prevent disease is to learn about it and act accordingly.