What are the other Names for this Condition? (Also known as/Synonyms)

• High Blood Pressure causing Renal Disease
• Kidney Disease due to High BP
• Renal Disease due to Hypertension

What is Hypertensive Kidney Disease? (Also known as/Synonyms)

• Hypertensive Kidney Disease is a condition which results from the damaging effects of high blood pressure (or hypertension) on the kidneys. Apart from advancing age, uncontrolled diabetes and heart disease are key risk factors for the condition
• The kidney is important for releasing certain hormones that regulate blood pressure among other functions. When the kidneys’ ability to function is compromised, an individual is said to have kidney disease. And this development of kidney disease in turn, makes the blood pressure worse
• The main signs and symptoms of Hypertensive Kidney Disease include body swelling due to fluid accumulation, abnormal urine output, fatigue, and muscle cramps
• Hypertensive Kidney Disease is treated by bringing about certain lifestyle changes and through medications in the early stages; in the later stages, dialysis and kidney transplant may be required
• Prognosis of this condition depends upon the stage at which it is diagnosed. Hypertensive Kidney Disease is a slow, progressive condition that can eventually lead to kidney failure, if it is left untreated

Who gets Hypertensive Kidney Disease? (Age and Sex Distribution)

• Any individual with high blood pressure is prone to Hypertensive Kidney Disease.  However, elderly adults are more at risk
• Men are slightly more likely to get hypertension when compared to premenopausal women, and hence, they are reported to be more at risk than women
• It has been noted that African-Americans have a higher risk in comparison to Caucasians

What are the Risk Factors for Hypertensive Kidney Disease? (Predisposing Factors)

The key risk factors for Hypertensive Kidney Disease, which can be described as Kidney Disease due to High Blood Pressure, include:

• Poorly-controlled diabetes
• Heart disease
• Family history of kidney failure
• Advancing age; older individuals are at an increased risk
• Race: Hypertensive Kidney Disease is more frequently seen in Afro-Americans
• Obesity
• Tobacco and/or alcohol use
• A high sodium and/or low potassium diet
• Stress

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hypertensive Kidney Disease? (Etiology)

Hypertension can contribute to as well as complicate chronic kidney disease in the following ways:

• When an individual has hypertension (high BP), it puts excess pressure on his/her blood vessels, which stretch in an attempt to relieve this added pressure. Eventually though, this stretching can lead to scarring and permanent damage of vessels found in the kidneys
• The vital function of kidneys is to filter out waste and excess fluid from blood and urine. It does this by passing blood through approximately a million microscopic filters called nephrons
• When the blood vessels of the nephrons are damaged, the ability of the kidneys to efficiently filter blood is compromised. In addition, damage due to hypertension can reduce the ability of blood vessels throughout the body to deliver blood to the vital organs. A reduced blood supply to any organ including the kidneys can result in serious complications
• The kidney secretes hormones that are responsible for regulating an individual’s blood pressure. The diseased kidneys are less able to carry out this function, further complicating the situation for individuals with an already high blood pressure

What are the Signs and Symptoms of Hypertensive Kidney Disease?

Hypertensive Kidney Disease may not cause symptoms in the early stages. As the disease progresses however, many of the following symptoms may be observed:

• Edema: The accumulation of fluid which can cause swelling, often in the lower limbs and face
• Appetite loss, weight loss
• Nausea
• Drowsiness/fatigue
• Trouble sleeping
• Abnormal urine output
• Decreased mental awareness
• Muscle twitches or cramps
• Headaches
• Anemia, due to lower levels of red blood cells
• Dry skin and/or chronic itching; darkened skin
• Chest pain; fluid accumulation in the lungs causing shortness of breath 

How is Hypertensive Kidney Disease Diagnosed?

The diagnosis of Hypertensive Kidney Disease may involve the following tests and exams:

• A thorough physical examination and evaluation of medical history
• Regularly checking blood pressure levels
• Urine examination: A urine dipstick test can detect the presence of blood or albumin in urine. Albumin is a protein that is normally contained in the blood stream, but can pass into urine when the blood vessels of the kidney are damaged
• Blood tests that include the following:
  • Serum creatinine test: In this test, the levels of a waste product of muscle breakdown called creatinine, is examined. This waste product is usually filtered out of blood into urine for excretion, but damage to the kidneys can cause its retention in the blood vessels
  • Estimated glomerular filtration rate (eGFR) test: This test is used to estimate how much blood is filtered by the kidneys every minute. An eGFR below 60 may be a sign of kidney damage, while a score below 15 suggests kidney failure

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hypertensive Kidney Disease?

The possible complications of Hypertensive Kidney Disease include the following:

• Fluid retention, which could cause edema (swelling) of the face, arms, or legs, as well as hypertension and fluid buildup in the lungs
• Heart attack, atherosclerosis
• Elevated potassium levels, which can potentially inhibit normal cardiac function
• Increased risk of bone fractures due to elevated blood phosphorous levels
• Potential damage to the central nervous system can affect concentration and personality
• Seizures
• In pregnant women, the condition may lead to miscarriages
• Inflammation of the pericardium (a membrane which surrounds the heart)
• Weakened immune response and greater susceptibility to infection

How is Hypertensive Kidney Disease Treated?

The treatment of Hypertensive Kidney Disease may include the following measures:

• Lifestyle changes:
  • Reduced intake of sodium, potassium, and phosphorous
  • Reduced consumption of foods that have higher levels of saturated fat and cholesterol
  • Smoking cessation and reduction of alcohol consumption
  • Undertaking moderate exercising, 30 minutes a day for 5-6 days each week
  • Reduced consumption of protein 
• Medical intervention:
  • Administration of medications to control blood pressure, such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, or vasodilators
  • Diuretics to reduce water retention and blood volume
  • Dialysis or kidney transplant, in the case of end-stage kidney disease

How can Hypertensive Kidney Disease be Prevented?

The following measures could help prevent Hypertensive Kidney Disease:

• Keeping blood pressure regularly under control
• Avoiding smoking completely
• Reducing/maintaining body weight to a healthy level
• Avoiding excessive alcohol consumption
• Paying close attention to usage directions on over-the-counter pain relievers and other medications, as well as those prescribed by the healthcare provider. Over-consumption can lead to irreversible kidney damage
• Undertaking suitable dietary and lifestyle modifications

What is the Prognosis of Hypertensive Kidney Disease? (Outcomes/Resolutions)

• If Hypertensive Kidney Disease is detected and controlled in the initial stages of progression, the disease can generally be controlled via one or multiple treatment options. Early control of high BP decreases the risk of kidney damage and improves the prognosis
• The disease tends to progress very slowly, but if left untreated, can eventually develop into end-stage kidney failure. This stage requires treatment measures, such as dialysis or kidney transplantation, for survival. In such cases, the prognosis is poor

Additional and Relevant Useful Information for Hypertensive Kidney Disease:

Hypertension is often asymptomatic and may not present any signs and symptoms. Regular check-ups can help an individual (and the healthcare provider) monitor and manage elevated blood pressures better.