Hypertension is the second leading cause of chronic renal failure

High blood pressure often causes chronic kidney failure

Kidney disease is often due to high blood pressure. This is the second leading cause of severe kidney disease after diabetes, according to the German Hypertension League in a recent announcement on the occasion of World Kidney Day on 8 March. By timely and consistent treatment of high blood pressure, chronic kidney damage is often preventable.

Due to high blood pressure, the kidneys are permanently affected and can fulfill their function only limited. The result is chronic kidney failure. The nephrological associations estimate that 24 percent of such chronic kidney failure in Germany is due to high blood pressure, according to the announcement of the German Hypertension League. Early treatment could prevent many of these kidney diseases.

Kidneys perform at their best every day

The kidneys have to perform at their best every day. "About 300 times a day, the blood in the kidneys is filtered and freed of pollutants," reports the German high pressure league. This work is completed in each kidney of about one million microscopic kidney bodies, which are connected to a canaliculi, in which the urine is produced. In their entirety, these units are called nephrons. According to the experts, they can be damaged by high blood pressure.

Critical loss of renal corpuscles

"Already in healthy people, it comes to the loss of nephrons in the course of life," said the CEO of the German Hypertension League Professor. med. Bernhard Krämer, Director of the V. Medical Clinic at the University Medical Center Mannheim. The destruction of the kidney corpuscles, however, is accelerated in people with high blood pressure, "so that in the end not enough nephrons are available to rid the blood of metabolic waste."

Many dialysis cases attributed to hypertension

For example, around 20 to 30 million people in Germany with hypertension are at the same time at an increased risk of kidney disease. Nearly a quarter of cases of chronic renal failure, according to the high-pressure league goes back to high blood pressure and "thus the high blood pressure in Germany would be responsible for 20,000 of over 80,000 dialysis cases," emphasizes Professor Krämer. However, many diseases are preventable by a timely and good treatment of hypertension.

What therapeutic options exist?

"Not only do we have a range of medicines that lower blood pressure and thus protect the kidneys," but "some agents, such as the ACE inhibitors or AT1 antagonists, can also lower and often lower blood pressure in kidney disease by inhibiting angiotensin II prevent further deterioration of kidney function, "explains Prof. Bernhard Krämer. In view of the relationship between blood pressure and kidney, the experts also advise all patients with high blood pressure to have their kidney function checked regularly.

Kidney can also be the cause of hypertension

Renal function is checked by examining the urine for albumin, which is increasingly excreted in many kidney diseases. A 24-hour blood pressure measurement gives first clues as to whether the high blood pressure has its cause in the kidneys. Because in this direction, there is a connection. For example, hypertension may occur if there is a narrowing of the renal arteries. If the kidneys are the cause of high blood pressure, "there is often a slight drop in blood pressure, which occurs in the after hours," explains Professor. Ulrich Wenzel from the University Medical Center Hamburg-Eppendorf.

How can renal hypertension be treated??

Ultrasound and laboratory studies, according to the experts usually determine how the kidneys are the cause of increased blood pressure. In addition, "in a narrowing of the renal arteries in selected cases angiography with dilation and stent insert improve blood pressure and kidney function," reports the German High Pressure League. In patients whose blood pressure is definitely not lowered by medication, a sclerotherapy of nerve fibers in the renal arteries to lower blood pressure can be considered. According to Professor Wenzel, however, this is currently only used in exceptional cases and in clinical trials.

According to the German Hypertension League, a kidney-related high blood pressure can be alleviated by a healthy lifestyle. Important factors are:

• A refrain from smoking, as it prevents premature calcification of the renal arteries.
• A low-salt diet, as this relieves the kidneys, which are also responsible for the excretion of excessively ingested salt.

In addition, hypertension can be relieved naturally by stress reduction and a healthy diet, although the negative effects of excessive salt intake can not be compensated. This should therefore be reduced to the lowest possible level (maximum 6 grams per day for adults, DGE recommendation). (Fp)