High blood pressure and kidney disease

High blood pressure is a major cause of kidney disease and kidney failure (end-stage renal disease). Hypertension can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult.

What are the symptoms of kidney disease?

The symptoms of kidney disease include:

• High blood pressure.
• A decrease in the amount of urine produced or difficulty urinating.
• Oedema (fluid retention), especially in the lower legs.
• A need to urinate more often, especially at night.

How is kidney disease diagnosed?

As with high blood pressure, you may not realise you have kidney disease. Certain laboratory tests can indicate whether your kidneys are eliminating waste products properly. These tests include serum creatinine and glomerular filtration rate (GFR) as elevated levels of serum creatinine and reduced GFR rates can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.

Who is at risk for kidney disease due to high blood pressure?

Kidney disease caused by high blood pressure affects every group and race. However certain groups are at higher risk, including:

• People who have diabetes.
• People with a family history of high blood pressure and kidney disease.
• People who are black of African or Caribbean descent.
• People who are of South Asian origin.

How can I prevent kidney disease?

To prevent kidney damage from high blood pressure:

• Try to keep your blood pressure under control.
• Make sure you get your blood pressure checked on a regular basis.
• Eat a proper diet.
• Take the medication your doctor prescribes.

How is kidney disease treated?

For patients who have high blood pressure and kidney disease, the most important treatment is to control your blood pressure.

If you are 55 or older, or if you are black of African or Caribbean descent (not mixed-race), then the first choice for treatment is a calcium-channel blocker or a thiazide-type diuretic. 

If you are younger than 55 and not black, the first medicine that you will usually try is either a diuretic or an ACE inhibitor. Some people develop a cough when taking an ACE inhibitor. If this happens in your case, your doctor will prescribe a different medicine.