Renal Hypertension: High Blood Pressure and Kidney Disease
More than 100 million Americans have high blood pressure, also referred to as hypertension. The causes of it can vary greatly, though the largest contributors are weight, diet, age, smoking, high alcohol consumption, a lack of exercise and genetics.
Consistently high blood pressure is the second leading cause of chronic kidney disease (CKD), outranked only by diabetes. Kidney disease is not curable unless the patient undergoes an organ transplant; and if left untreated, CKD will end in fatality in every single case. In order to ensure kidney health, it's important to understand the risk factors involved and how to steer clear of them. The relationship between blood pressure and CKD is sort of a two-way street -- yes, hypertension is a leading cause of CDK, but "renal hypertension" is a term that refers to high blood pressure that is also caused by kidney disease. Here we'll go over what high blood pressure is and how it affects the kidneys.
What is blood pressure and how is it measured?
Blood pressure is the measurement of the force applied to artery walls as blood flows through them. Imagine your arteries are a garden hose. When you turn the water on, the water flows at a consistent pace. But when you put your thumb over half of the nozzle, the water shoots farther because the same amount of water is trying to fit through a smaller space, increasing the pressure. The same principle applies to arteries and blood flow: as the artery gets narrow, the blood flows more quickly (aka higher pressure).
How does blood pressure affect the kidneys?
When arteries that deliver blood to the kidneys become narrow or stiff, blood pressure becomes high. When it stays elevated, it stretches the blood cells and weakens them throughout the body. The main role of the kidneys is to filter waste and excess fluids from the blood and expel them as urine -- but as the kidneys' blood vessels become weakened, the kidneys cannot efficiently filter out harmful waste. As they cease to remove fluid in the blood cells over time, the additional fluid will cause blood pressure to increase even more, creating a vicious cycle. High blood pressure damages the kidneys and as the kidneys become damaged it increases blood pressure. This is what renal hypertension is.
How can I avoid renal hypertension?
Since CKD does not show symptoms until it has reached stage 3, it's important to get regular checkups with your doctor. While you're there, inform them that you would like them to do blood tests for CKD just to confirm your kidney health. That being said, there are measures you can take to alleviate high blood pressure without having to visit a doctor:
Dialysis Travel: How to Take a Trip With Kidney Disease
If you or a loved one are a kidney patient, you know that regular dialysis is crucial to staying alive -- especially in the later stages of the disease. Some people need to travel for work, some people want to travel for pleasure. Regardless of the reason, travel might play a major role in one's livelihood and quality of life. That's why it's important for kidney patients to know: yes, you can travel if you have kidney disease. You don't have to let dialysis weigh you down. Most dialysis centers have experience in dealing with patients who require transient dialysis, so most of the time it shouldn't be much of a hassle. Nevertheless, here are some useful tips for traveling with kidney disease.
Plan Ahead With Your Doctor
You probably already know how often you need to receive dialysis treatment, so plan your travels at least 6 to 8 weeks in advance with that in mind. When creating a travel itinerary, ensure that there is an open dialysis center be able to accommodate you in whatever city you're visiting and plan accordingly. Call the dialysis center ahead of time to schedule your treatment and ask them what paperwork you'll need to bring with you. Ask your doctor for recommendations and get approval from them or get help from a social worker.
Become Familiar With Local Cuisine
One crucial aspect of being on dialysis is ensuring you eat a healthy diet that doesn't interfere with treatment. You probably have discussed your nutrition needs with a dietician and already know the types of foods you can and can't eat. But whenever you decide to travel (especially overseas or to places you've never been), do some brief research to get familiarized with local cuisine. Check with your doctor or dietician to make sure you're able to eat local foods, especially while traveling overseas.
Bring Necessary Documentation to Dialysis Centers
When you're planning out your travels and you call to make appointments at your desired dialysis center, be sure to ask what they need from you during and before your first visit. Here are some of the essentials you'll need:
What About Traveling With Peritoneal Dialysis?
We previously explained the difference between peritoneal dialysis and hemodialysis. Those on peritoneal dialysis probably won't need access to a dialysis center because they do home treatment by themselves. However, they should still take extra steps to plan ahead and arrange for backup treatment in the event of equipment failure. Contact the nearest available dialysis center where you'll be traveling to and ensure that they will be able to accommodate you if needed.
What's the Difference Between Type 1 and Type 2 Diabetes?
Diabetes is a common disease in the United States. It disallows the body to process insulin, which it converts into energy. Around 29 million Americans are afflicted with either Type 1 or Type 2 diabetes, and there are an estimated 8 million more undiagnosed.
It's important to recognize the symptoms of diabetes because, while managing it is relatively easy, if it goes untreated it will eventually lead to some serious complications down the road. Diabetes remains the leading cause of kidney failure, which is fatal if not treated quickly. Your kidneys are responsible for filtering out waste from your bloodstream and when a patient is diabetic, it damages the body's small blood vessels. This renders the kidneys ineffective and they slowly stop cleaning the blood, which eventually leads to kidney disease.
What is Type 1 Diabetes?
Type 1 diabetes accounts for 5-10% of all diabetic patients. It's most common in children and although its cause is largely unknown, it is suspected to be due to a genetic defect. In Type 1, the pancreas does not produce enough insulin and the patient will be required to take insulin shots for their entire life. There is no permanent cure and it cannot be prevented, only managed and suppressed.
What is Type 2 Diabetes?
This is the more common form of diabetes, accounting for 90-95% of the diabetic population. It occurs in people over 40 years old and is commonly referred to as "adult onset diabetes". This is because the pancreas DOES produce insulin, but the body doesn't know how to efficiently process it. This is normally controlled by diet or medication, but in some extreme cases, patients take insulin. With proper care, exercise, diet and possibly medication, Type 2 diabetes can be reversed.
Symptoms of Diabetes
Type 2 diabetes symptoms often don't show until some damage to the body has been done. Type 1 symptoms develop fairly quickly and are much more severe, although the two types share many of the same symptoms:
Image source: Medical News Today
The Difference Between Hemodialysis and Peritoneal Dialysis
Kidney disease is a very serious ailment that affects 30 million adults in the US, with millions more at risk. It inevitably becomes fatal if left untreated. The most effective way to treat kidney failure is through dialysis, of which there are two types -- hemodialysis and peritoneal dialysis. In order to understand these two processes better, it's important to first thoroughly understand what the kidneys do and why they are significant.
So, What DO Kidneys Do?
Your kidneys are crucial to filtering waste and harmful substances out of the bloodstream. They absorb essential vitamins and nutrients, expelling everything else out of the body in the form of urine. Kidneys also regulate your body's hydration levels and assist in hormone production. If your kidneys fail, they allow harmful elements into the bloodstream, leading to various complications with the central nervous system, diabetes, heart problems and more. You can read further on the subject here.
Kidney dialysis is the most effective way to treat kidney disease. It's a process that allows artificial regulation of hydration, hormone production and waste filtration. Essentially the process conducts the kidneys' duties. Treatment is administered on average for about 4 hours, 3 times per week. Frequency depends on the severity of the disease and the patient. There are two types of kidney dialysis: hemodialysis and peritoneal dialysis.
What is Hemodialysis?
Hemodialysis is a process that cleans the blood via an external artificial kidney -- a machine called a dialyzer. The doctor will create an exit and entry point for the blood, normally done by arm surgery. The blood is drawn out of the body, through IV tubes that send it into the dialyzer, which filters out the waste and retains essential nutrients. It then begins pumping the newly cleaned blood back into the body.
This process is done either in a hospital, dialysis center or, depending on the severity of the disease and the patient's personal situation, at home. Treatment normally takes place for around 4 hours for 3 times a week, sometimes more frequently if done at home. If the kidney disease is caught early enough, hemodialysis may not be needed for the long-term. As long as the patient maintains a strict and healthy diet, as instructed by the doctor, the kidneys may heal over time and the patient will see restored functionality. However, if the disease is progressed to severe levels, which is often the case, hemodialysis will be administered for the rest of the patient's life unless they receive a kidney transplant.
Peritoneal dialysis shares the same basic principles as hemodialysis -- to do the jobs that the kidneys no longer can -- albeit in a different manner. The first type of peritoneal dialysis is called Continuous Ambulatory Peritoneal Dialysis (CAPD). It's machineless, so there's no need to visit a dialysis center or hospital 3 times a week. Instead, the filtration system is within the body. A special cleansing fluid is administered via IV into the abdomen, left for several hours to clean the blood, and then later drained. The administration and draining process take around 30 minutes each and is done around 3-5 times a day. During this time, the patient can carry on about their normal day.
A second type of peritoneal dialysis, called Automated Peritoneal Dialysis (APD), is the same as CAPD, though rather than manually administering and draining the cleansing fluid from the body, a machine does it (hence the term "automated"). It is often done at night while the patient sleeps.
While there are different types of dialysis, there are many factors that play a role in which will be administered. These factors often include the patient's lifestyle, line of work, disease severity, and personal preferences. Your kidney specialist will explain more in-depth the pros and cons of each type of dialysis to find what's best for you. That being said, catching the kidney disease early enough and avoiding treatment altogether is much more convenient. So if you or a loved one suffer from, or are at risk for kidney disease, please contact us for an examination.
Common Myths About Chronic Kidney Disease
The gradual degradation of the kidneys, known as chronic kidney disease (CKD) is a more serious issue than most people realize. The kidneys are responsible for a host of bodily procedures that keep your blood clean, your body hydrated, and various hormones regulated (among other crucial responsibilities.) Yet, there are many myths surrounding CKD, its prevalence and severity.
Myth: Chronic kidney disease is curable
Fact: Chronic kidney disease is NOT curable. Those afflicted with CKD will undergo one (or even both) of two options: dialysis and organ transplantation. Dialysis is extremely effective at slowing the progression of kidney disease, but ultimately is NOT a cure. Since CKD will always lead to death if untreated, it's important to know that transplantation is the closest thing to a cure. However, if a patient does not commit to improving their health habits after the transplantation, the same lifestyle factors that led to CKD in the first place could persist. Additionally, the waiting list for a suitable donor could take anywhere from 3-10 years (if one is ever found at all), so it's quite common for patients to undergo dialysis until they find their new kidney.
Myth: I haven't shown symptoms, so I don't have to worry
Fact: Patients don't actually exhibit symptoms of kidney disease until it has already significantly progressed. There are 5 distinguishable stages of chronic kidney disease, each measuring the progressive level of deterioration. Stage 5 is called end-stage renal disease, meaning the kidneys have lost all function and emergency surgery is needed if the patient intends to live. Symptoms for kidney disease don't surface until stage 3.
Myth: Everybody is at equal risk for developing kidney disease
Fact: There are many factors that play into who is at risk of CKD. Adults with diabetes, high blood pressure, heart disease, obesity, and a family history of it are at higher risk. Additionally, CKD affects a disproportionate amount of African Americans and Hispanics. The Centers for Disease Control (CDC) estimates that African Americans are 3 times more likely to develop CKD than Caucasians, while Hispanics are 35% more likely than Caucasians to develop it.
Myth: Kidney disease isn't very common
Fact: An estimated 15% of the American population has kidney disease, but around 96% are unaware of it, since symptoms take a while to show. That's more than 30 million Americans.
Myth: It's difficult to test for CKD
Fact: All it takes to test for CKD is a simple blood or urine test from your doctor. If you feel that you or a loved one are at risk of developing kidney disease, it would be best to schedule an appointment sooner rather than later. To find out more about how doctors test for CKD, check out our extensive article on the subject.
What To Expect When Getting Tested for Kidney Disease
The vast majority of people that suffer from chronic kidney disease (CKD) are unaware of it. In fact, an estimated 90% of stage 3 CKD patients do not know they have it and that it's getting worse with each passing day. This is largely due to the fact that kidney disease does not exhibit symptoms until the disease has progressed significantly -- stage 3 is when the first signs surface. Because of this, it's important to know if you're at risk so you can get tested regularly, earlier.
However, when you finally do make the decision to get tested for kidney disease, it's important to be prepared and know what to expect. There are a couple methods, but how do doctors test for kidney disease?
Doctors will typically utilize two main methods of testing for chronic kidney disease, the first being a urine test. Depending on the situation, there are a few signs doctors look for:
Blood Test | Glomerular Filtration Rate (GFR)
Glomeruli are the tiny filters in the kidneys that ensure waste does not enter the bloodstream. Your glomerular filtration rate measures the rate (in milliliters per minute) at which blood passes through the glomeruli. A lower rate indicates that smaller amounts of blood are being cleaned.
Doctors may also utilize scanning technologies in determining the severity of kidney disease. They may use ultrasounds and CT scans to check for tumors or abnormal growths on the kidneys.
In some rare cases, kidney biopsies may be conducted. These are usually only reserved for patients that are experiencing transplant rejection, or when doctors need to figure out the severity of physical damage done to the kidneys.
The 5 Stages of Chronic Kidney Disease (CKD)
The kidneys have a variety of responsibilities including regulating bodily hydration, filtering waste out of the blood stream and producing hormones. So as you can imagine, if the kidneys fail to do their job, serious health complications will arise if left untreated. In fact, without dialysis treatment or an organ transplantation, kidney disease has a 100% fatality rate. There are 5 stages of kidney disease, identified by glomerular filtration rate (GFR), which is the measurement of how much blood is being filtered and cleaned by the kidneys in milliliters per minute. A lower GFR indicates lower volumes of blood are being cleaned, signaling kidney trouble. It's important to know each stage of CKD, how they impact the body and what you can do about it.
Stage 1: Minimal Function Loss (GFR 90 - 120)
The first stage of kidney failure is very minor. It's categorized by the kidneys starting to lose partial function, although no symptoms will show. It will only be detectable by blood test, so it's important to get regular checkups and request that your doctor do blood work. If your doctor does inform you that you are in the first stage, here's what you can do to minimize the risk of it progressing:
Stage 2: Mild - Moderate Loss of Function (GFR 60 - 89)
Again, symptoms generally won't show up until the later stages of kidney disease, but your doctor can determine if you're at this stage via blood test. If you happen to find yourself in stage 2, don't panic. This is still an early stage in the progression of CKD and it's possible to manage with the same recommendations as step 1, but you may want to additionally talk to your doctor about taking over-the-counter medication and learn everything you can about kidney disease and possible treatments.
Stage 3: Moderate - Severe Function Loss
This stage is actually broken up into two different subsets: 3a and 3b. Stage 3a is characterized by a GFR between 45-59 mL/minute while 3b is between 30-44 mL/minute. Stage 3 is where CKD starts to manifest itself through symptoms, including:
Stage 3 is when things start to get really serious. It's around this time that you'll need to see a nephrologist in order to receive individualized treatment and lifestyle recommendations, including consulting a dietician. While each patient is unique in their circumstance, here are some broader expectations when it comes to diet:
Stage 4: Severe Loss of Function (GFR 16 - 29)
Stage 4 of CKD indicates that it is time to see a nephrologist, as you'll need dialysis or transplantation in the near future. You can expect to see a doctor every very frequently, at least once every few months, where frequent blood tests will be done. Symptoms will become more apparent as:
Stage 5: End Stage Renal Disease (GFR 15 or less)
The final stage of CKD is referred to as kidney failure or end stage renal disease. It's when the kidneys have ceased to function completely and a transplantation or dialysis are needed immediately in order to live. As toxins begin to infect your blood, you will feel an overall sense of illness in addition to the many symptoms outlined above.
End stage renal disease is no joke. Your kidneys are responsible for a myriad of bodily regulations, so treating it is imperative if you intend to live much longer. Much of the treatment will involve dialysis or transplantation in addition to drastic lifestyle changes, dietary improvements and medication. CKD is best caught early and can even be reversible if caught soon enough. So if you find that you're at risk of chronic kidney disease, schedule a consultation with a kidney specialist today.
Major Risk Factors for Kidney Disease
Did you know that 1 in 3 adults in the United States is at risk for kidney disease? While it can actually affect anybody, there are some major lifestyle factors that will sharply increase your susceptibility.
Hypertension is a main factor for being at risk of kidney disease and in turn, there are many risk factors involved in having hypertension. It's essentially high blood pressure, which is both a cause and symptom of kidney failure because your kidneys regulate blood flow throughout the body.
Leading a healthy lifestyle will reduce your blood pressure, and therefore reduce your risk of kidney failure. This includes quitting smoking, eating a healthy diet with less sodium, ceasing to drink excessive amounts of alcohol, avoiding obesity and exercising regularly -- not necessarily vigorously, just enough to mitigate a sedentary lifestyle.
Diabetes is the top cause of kidney failure and chronic kidney disease. We've covered the different types of diabetes in previous articles (LINK TO TYPE 1 V TYPE 2), but while type 1 diabetes is genetic, there are steps you can take to avoid type 2. Yet again, it's extremely important to stop smoking, get some exercise and watch what you eat.
There's no "one size fits all" solution when it comes to dietary needs, so seeing a nutritionist will be your best bet if you already have diabetes. Be prepared for constant monitoring of blood sugar, vitamins, fat, fiber, carbs, fat and salt. Generally speaking, diets for diabetics will be low in carbs, fats and calories but high in fiber and nutrients. You'll need to eat a lot of fruits, vegetables, whole grains and healthy proteins like fish.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, African Americans, Hispanics and Native Americans are more at risk for kidney disease. Doctors don't know exactly why this is, but they suspect it's because they have high rates of diabetes and hypertension, both of which are the two major factors for kidney failure. Additionally, lack of access to quality healthcare plays an important role in these statistics.
If you or a loved one are affected by diabetes and/or hypertension, it never hurts to get a check-up. Kidney disease is always fatal if left untreated; and symptoms don't usually arise until the kidneys have significantly declined to an unhealthy level. Our doctors at Milwaukee Nephrologists are all specially trained in all aspects of kidney health and management, so schedule a consultation today.
What You Should Do After Being Diagnosed With Kidney Disease
Going to the doctor is rarely a pleasant experience, but if you've noticed some health issues and finally get the courage to talk to a doctor, you'll be better for it. If you're ever diagnosed with chronic kidney disease (CKD), it's definitely not a good diagnosis, it's not the end of the world. In addition to treatment options such as dialysis or transplantation, there are things you can do to mitigate the harmful effects of CKD. Since symptoms don't surface until stage 3, there's a good chance that it's already progressed to that point or worse, so getting immediate treatment and taking your own health into your hands is crucial.
Strive for a healthier lifestyle
It may sound like beating a dead horse because it's great advice for everybody, regardless of health status, but exercise is extremely important. Cardiovascular exercise in particular when it comes to CKD. You don't have to become a gym rat or spend hours each day working out to improve your health. Even a 30-40 minute walk and stretches each day goes a long way.
One of the most crucial steps you can take is to quit smoking. Tobacco use is associated with many types of deadly cancers and diseases and kidney failure is no exception. Smoking causes restrictive blood flow to vital organs, causing damage to the body. Unfortunately, there is no way to fully cure CKD (except with transplantation, but the waiting list can last a long time), dialysis merely slows the progression to a snail's pace. Tossing tobacco into the mix will negate that and "step on the accelerator" for the disease's progression, so to speak.
Another thing you'll need to do is improve your diet. The best way to go about this is to consult with a dietician because each patient is different and when it comes to dialysis treatment, there are many dietary restrictions to keep in mind. Previously, we've covered industry-known dietary regimens such as the DASH (Dietary Approach to Stop Hypertension) diet. We can make generalized recommendations all day, but realistically, your personal doctor will need to instruct you what to do.
Understand the ins and outs of your condition
We at Milwaukee Nephrologists believe not only in reliable and top-quality healthcare, but also educating patients about their condition. We strive to inform everybody about the most important aspects of CKD in our blog section. Those diagnosed would find it particularly advantageous to know why the kidneys are important and what they do, the various stages of the disease, what to expect from dialysis, and the risk factors associated with CKD. They say knowledge is power and our library of informative articles will help to empower you through the duration of your treatment.
Work to cure your high blood pressure
High blood pressure can cause a condition known as renal hypertension, which is both a cause and effect of kidney disease. That's right, renal hypertension is a cycle -- it damages the kidneys and that damage causes high blood pressure. The result is that the disease will progress quicker, so it's really in your best interests to manage your high blood pressure. Your doctor will make dietary recommendations and, if it's a big enough issue, will prescribe you proper medication.
While there's really no way to fully cure a CKD without kidney transplantation, you still have the potential to live a happy and fulfilled life. Become informed about your disease and make healthier choices to mitigate the effects of CKD. If you or a loved one are at risk for developing kidney failure, schedule a consultation today.
What Are The Symptoms Of Kidney Disease?
Your kidneys are extremely important -- they filter out waste from the bloodstream and then expel it from the body as urine, so when the kidneys start to fail, it causes harmful waste to enter the body; other problems and diseases will start to surface. Early stages of kidney disease/kidney failure don’t have obvious symptoms, but if left untreated, it is always fatal. If symptoms of kidney disease DO come to light, it means they have already taken some damage and it’s imperative to seek treatment immediately. Here are some of the most common symptoms of kidney disease: