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What is Hypertensive Kidney Disease?

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Hypertensive kidney disease is kidney failure caused by high blood pressure. In this lesson, we will learn about blood pressure and how that causes hypertensive kidney disease.

What is Blood Pressure?

Most people know what it means to have your blood pressure checked, but do you know what blood pressure really is? Your heart beats to pump blood through your body to provide it with oxygen and nutrients essential for life. Arteries are the blood vessels that carry the oxygenated blood and veins carry the deoxygenated blood back to the heart.

Blood pressure is the pressure of the blood in the arteries. Systolic blood pressure is the pressure in the arteries when your heart beats and diastolic blood pressure is the pressure in the arteries between heartbeats, while your heart is at rest. Blood pressure is written with the systolic number over the diastolic number. Normal blood pressure is 120/80 and blood pressure above 140/90 is considered high blood pressure (hypertension).

Measuring Blood Pressure
blood pressure

You may have high blood pressure and not even know it. There are generally no symptoms to alert you that you have high blood pressure. Kidney damage leading to chronic kidney disease (CKD) is often caused by hypertension. It causes 15-25,000 cases of end-stage renal disease (ESRD) in the United States every year! It's important to manage your blood pressure to maintain your kidney's health. Let's learn more about how the kidneys work to help us understand the severity of this.

How do your Kidneys Work?

You have two kidneys that are located in your upper abdomen against your back. Kidneys are a complex structure that your blood passes through to be filtered. In the kidneys, there are tiny nephrons that are responsible for filtering waste and fluid from your blood. This is then excreted from your body in your urine.

Anatomy of Kidneys

Kidneys are also responsible for helping to regulate your blood pressure. You can't live without functioning kidneys or waste and fluid will build up in your body. So now let's look at what happens to your kidneys when you have chronic high blood pressure.

What is Hypertensive Kidney Disease?

Hypertensive kidney disease is kidney damage that is caused by chronic high blood pressure. High blood pressure is the second leading cause of CKD and ESRD.

When you have high blood pressure, over time this damages the lining of your arteries. Blood cells collect at the injured site, and over time, fat and cholesterol also gather at this site. This develops plaque in your arteries which results in narrow, thick, and hard arteries. When this occurs, the arteries are not able to deliver enough blood to their destination. It might help you to compare your arteries to the plumbing in your kitchen sink. If your pipes have build-up within them, they are more narrow. Therefore, the water in your sink may drain very slowly. This is basically the same concept when your arteries become narrowed.

When the arteries providing blood to your kidneys are damaged, ultimately the tiny nephrons in the kidney are not receiving enough oxygen and nutrients because of the decreased blood flow. If they don't get enough oxygen and nutrients, they lose their ability to filter the blood effectively. If they aren't filtering waste and fluid from the body, blood pressure is even higher due to the increased fluid. This becomes a snowball effect. The increased blood pressure damages the kidneys ,so they can't filter. This results in fluid and waste buildup in the blood, which causes increased blood pressure and so on and so forth!

Just like high blood pressure, early kidney damage also doesn't have any symptoms, so you likely don't know that you have any problem.

Your doctor may detect a problem when he orders blood work. Your creatinine level will be elevated because your kidneys aren't effectively filtering the creatinine out of your blood. He will also evaluate your proteinuria levels which is the presence of protein in your urine. Normally as your kidneys filter waste, they leave protein in the body. However, with damaged kidneys, protein may be present in the urine.

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