Can you prevent kidney failure if you have resistant hypertension? Resistant hypertension is high blood pressure that is difficult to control on two medication requiring 3 different classes of blood pressure medication (usually including a water pill called a diuretic). Most times resistant hypertension can be controlled with the 3 classes of antihypertensive medication.
The simple answer is that it depends. Certainly you can prevent kidney failure that occurs due to uncontrolled resistant hypertension by keeping your blood pressure controlled. You see the problem with most kidney failure is the damage that is done to the kidneys’ filter also know as the glomerulus. If you want to prevent kidney failure or further damage to your kidneys, you have to protect the filter.
Your kidneys filter your blood to get waste out of your body. High blood pressure damages the filtration system of the kidneys known as the glomerulus filtration rate (GFR). Your GFR lets your doctor know how well your kidneys are working to get rid of the creatintine from the normal breakdown of your muscles, and it determines the stage of kidney failure.
Uncontrolled resistant hypertension is a common cause for kidney failure in the United States. Kidney failure is easily diagnosed by your health care provider using blood testing called a blood creatintine level to determine a particular stage of kidney failure. Creatintine is a waste product that comes from your muscles and your kidneys do a good job removing it from your blood.
It is also important to determine if you have protein in your urine, which is caused by the loss of protein from the body that is being filtered out into the urine. Normally your body holds on to protein and it cannot be lost in your urine. Your doctor can easily test your urine protein with a urine analysis test. You would just provide your doctor with some urine in a specimen cup provided by your doctor. Your doctor can conduct this test in the office or send the urine to the laboratory for testing.
So how does resistant hypertension cause kidney failure? The high pressure from uncontrolled hypertension or uncontrolled resistant hypertension damages the blood vessels in the kidneys. The damaged blood vessels cause a decrease in filtration of your body’s waste. This shows up in your blood test as a decrease in your GFR. Your body’s waste buildup in your body causing an increase in your creatintine The extent of the build up of waste in your blood is measured by your creatinine level. The damage also cause the kidneys to leak important products into your urine such as protein and blood.
Kidney failure from hypertension or resistant hypertension can be prevented if your blood pressure remains controlled. So monitor your blood pressure routinely at home using a home blood pressure monitor. See this link for the most accurate monitor monitor that I recommend. Call your health care provider if your blood pressure mostly run higher than the target goal that your provider set for you. Your antihypertensive medications will likely need to be adjusted to better control your blood pressure.
Your health care provider will want to get your creatintine blood level and urine protein level that is included in a metabolic panel at least every 6 months to every year to monitor your kidney function for damage by resistant hypertension. It is important to detect kidney damage early to prevent kidney failure.
Chronic Kidney disease is silent just like hypertension. Usually in Stages 1 , 2 and 3, there are no symptoms. Stage 1 Kidney Failure (GFR is 90 or more) usually does not involve symptoms that are visible except probably leg swelling. Stage 2 Kidney Failure the GFR=60-89 . Stage 3 Kidney Failure is the most common kidney failure, and it is associated with a GFR of 30-59, which indicates a significant reduction in kidney function. Stage 4 Kidney Failure (GFR= 15-29 ) with usually symptoms and decrease in appetite or shortness of breath. Stage 5 Kidney Failure (GFR is 15 or less) more with more severe symptoms like fatigue, swelling in legs, metal or bitter taste in your mouth, and nausea and vomiting.
Dialysis or kidney transplantation is usually necessary if your GFR is less than 10 and you have symptoms such as frequently urinating (especially at night), puffiness around your eyes, swelling in your legs, ankles or feet, bubbles in your urine, low blood count, feeling really tired or fatigued, severe itchiness, or a metal taste in your mouth. Stage 5 is associated with the most symptoms and usually requires dialysis and eventually kidney transplantation to keep you alive. Some people experience extreme itchiness, fatigue, leg swelling, shortness of breath and muscle cramps in Stage 5.
What have you done to control your blood pressure to protect your kidneys from damage? If you are in any of the stages of failure, have you been told that you can protect your kidneys from further damage? Share your experiences, thoughts, and questions in the comment box below.
Join us on the next post when we discuss 3 things you can do to improve your GFR, which determines your kidney function.
