How Do Diabetes And High Blood Pressure Cause Ckd
High blood sugar levels and high blood pressure can damage blood vessels throughout the body, including the ones in the kidneys. Those blood vessels can then become less efficient at filtering blood, and are not able to deliver oxygen and nutrients to kidney tissue.
This reduced blood supply to the kidneys can then further damage their filtering system, and damaged kidneys can cause a buildup of waste and fluid that increases blood pressure even more.
Diabetes, high blood pressure, and CKD can often go undetected for years, silently causing damage throughout the body, so its important to know your risk and see your doctor regularly to be screened for these conditions. Getting proper treatment is key, and managing one condition can help you better manage the others. If you have CKD, the best way to slow or prevent kidney damage is to reach your blood sugar and blood pressure goals.
Diabetes High Blood Pressure And Kidney Disease
High blood pressure is one of the principal causes of kidney disease and kidney failure. When blood pressure is high, there is a large amount of tension inside the blood vessels that leads to damage. These vessels may constrict , which can cause a heart attack, stroke, or kidney failure.
High glucose and high cholesterol can also damage blood vessels. Thus people with diabetes who also have hypertension are at especially high risk for blood vessel damage. It usually takes years for blood vessels to completely constrict, and damage to blood vessels can be slowed down or somewhat reversed with treatment.
Diagnosis
Diagnosis of high blood pressure can only be done by having your blood pressure measured by a person trained in taking blood pressures. Usually, there are no obvious symptoms that indicate you have high blood pressure. If you have diabetes, the blood pressure is considered high if it is greater than 130/80.
Your blood pressure should be measured on multiple occasions, as blood pressure can vary throughout the day and it is normal to have occasional readings greater than 130/80. Blood pressure generally peaks in the middle of the day, and is lowest at night while you are sleeping. It is best to take blood pressure from the left arm, if possible, and should be taken after you have rested for 5-10 minutes. Your left arm should rest comfortably at heart level.
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How Do You Distinguish Sam From Fmd And Are These Different Diseases Or Varying Spectrums Of The Same Disease
SAM is often difficult to distinguish from FMD, as in this particular patient. There is much debate in the literature about whether these are two different conditions or different parts on the spectrum of the same condition. Slavin et al. have postulated that arteries that originally present as isolated aneurysms and dissecting hematomas may evolve into FMD . Two reports described follow-up lesions that were initially diagnosed as SAM but on follow-up imaging had evolved into lesions that would be considered more likely to be FMD . Classically, FMD presents more commonly in middle-aged women and has a predisposition for the renal arteries, thereby causing premature hypertension . SAM may be a subclinical process, and silent cases with small or absent gaps and no dissection may evolve into FMD because fibrosis of the reparative granulation tissue can metamorphose into lesions identical to medial fibroplasia or perimedial dysplasia . The frequent involvement of renal arteries in SAM may be congruent with the notion that this is an evolving process in which patients initially present with vascular lesions with aneurysms and dissections consistent with SAM and that these lesions evolve and become fibrotic and stenosed over time, which is more consistent with FMD.
What Is A Kidney Infection
Kidney infections are a type of UTI. The medical term for a kidney infection is pyelonephritis. Certain bacteria and viruses can cause these infections.
Experts believe that many kidney infections start as an infection of the lower parts of the urinary tract, such as the bladder or urethra. Many times, these infections happen when bacteria from your bowel enter your urinary tract through your urethra.
Its possible for a UTI to continue to move up your urinary tract, progressing from your bladder into your kidneys.
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Monitoring Your Blood Pressure
The first important step is to figure out whether your blood pressures high. Thats easy to do with a blood pressure cuff you can use one at home or see your GP, practice nurse or pharmacist for a regular check.
A one-off high reading is usually nothing to worry about but if its consistently high, you should speak to your GP about ways to lower it.
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Treatments For Renal Hypertension
Medications are used first to try to control high blood pressure in renal hypertension. The most important blood pressure medications to treat renal hypertension include:
- ARBs . Examples include candesartan, losartan, olmesartan and valsartan.
For most people with renal hypertension due to renal artery narrowing, medications can effectively control blood pressure. More than one blood pressure drug is often needed, however.
In some people with renal hypertension due to narrowing of the renal artery, even taking three or more medications every day may not adequately control blood pressure. In these situations, a procedure to improve blood flow to the kidneys may help.
Possible procedures include:
Angioplasty. A doctor threads a catheter through a large artery in the groin and advances it into the renal artery. A balloon is then inflated for a few moments. This widens the artery and improves blood flow.
Stenting. During angioplasty, a wire-mesh stent can be expanded inside the renal artery. The stent stays in place. This keeps the artery open after the balloon is removed. Research, however, has not shown that stenting is more effective than medication for most people with renal hypertension.Ã
Surgery. A surgeon can bypass the narrowed renal artery by sewing a healthy blood vessel next to it. Surgery is generally considered only when angioplasty and stenting are not possible, and isà only rarelyperformed.
What Causes High Blood Pressure
High blood pressure usually develops over time. It can happen because of unhealthy lifestyle choices, such as not getting enough regular physical activity. Certain health conditions, such as diabetes and having obesity, can also increase the risk for developing high blood pressure. High blood pressure can also happen during pregnancy.
You can manage your blood pressure to lower your risk for serious health problems that may affect your heart, brain, kidneys, and eyes.
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How Can I Prevent Or Slow The Progression Of Kidney Disease From High Blood Pressure
The best way to slow or prevent kidney disease from high blood pressure is to take steps to lower your blood pressure. These steps include a combination of medicines and lifestyle changes, such as
- being physically active
- managing stress
- following a healthy diet, including less sodium intake
No matter what the cause of your kidney disease, high blood pressure can make your kidneys worse. If you have kidney disease, you should talk with your health care professional about your individual blood pressure goals and how often you should have your blood pressure checked.
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How Do Kidneys Regulate Blood Pressure
Kidneys filter waste and impurities out of the bloodstream and remove them through the production of urine. But they have another important job as well: maintaining a healthy balance of salt and water in the body.
“If you have too much water or salt in your body, your blood pressure goes up,” explains Dr. Vidi.
Healthy kidneys sense any salt and water imbalances in your body and regulate it to keep your blood pressure in a heathy range.
More specifically, the kidneys produce an enzyme called renin, which in turn triggers the production of a series of hormones through the renin-angiotensin-aldosterone system . This system, together with a hormone called anti-diuretic hormone , maintains this healthy salt and water balance.
Special For Kidney Stone Patients
Having crystals in your kidneys, and being prone to repeated obstruction from stones, virtually all stone formers might best consider themselves as having CKDeven if glomerular filtrationis not reduced. Stone formers are at increased risk for both high blood pressure and overt kidney disease. So when you do your addition of risk factors, add 1 up front because you form stones.
That means your go into the higher risk bracket with only one other. If you are male, or older, too bad. You are already in a high risk category.
This is a powerful argument for all stone formers to attack every modifiable risk factor with zeal and impudence. Why tolerate any of them if exercise, a good diet, and restraint can eliminate risk factors you do not need? And, as for blood pressure, insist on the best possible outcome.
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How Does The Success Of Medicine Compare With The Success Of Procedures
Angioplasty and stenting have not been shown to be better than controlling blood pressure with medications. This is because, in most people, renal artery stenosis may be present but does not cause high blood pressure. In such cases, opening up the artery will not result in improved blood pressure.
It is suggested that this procedure be reserved for those whose blood pressure cannot be controlled by medications, who experience unacceptable side effects with their blood pressure medications, who developed rapidly worsening kidney function or who have a rapid build-up of fluid in their lungs called flash pulmonary edema.
Ways To Lower Your Blood Pressure
Here are some steps you may consider taking to help lower your blood pressure:
- Reduce stress: You may need to make changes in the hours you work, your activities, or even your relationships.
- Try slow, deep, rhythmic breathing: You may try meditation, yoga, or other practices that encourage slowing down and taking time to focus on your breathing.
- Prepare healthy snacks in advance: Youll be less likely to reach for processed foods if you already have fruits and veggies cut up.
- Sign-up for an exercise class or running group: Working out with friends can make it more fun and add accountability.
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Inclusion And Exclusion Criteria
The inclusion criteria were: the study design was a cross-sectional, casecontrol, or cohort study identified nephrolithiasis as exposure, including medical records, questionnaire, direct interview etc. the outcome measure was hypertension, including medical records, questionnaire, blood pressure measurement, direct interview etc. and odds ratio or hazard ratio or risk ratio , and the corresponding 95% confidence interval were reported or could be calculated. Reviews, letters, case reports, and animal studies were excluded.
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Are There Any Symptoms Of Elevated Blood Pressure From Kidney Disease
Elevated blood pressure is difficult to notice because it has basically no symptoms. The only way to know your blood pressure is high is by using monitoring equipment to provide you with detailed blood pressure numbers.
Even though high blood pressure has virtually no symptoms, there are a few common symptoms that may be linked to it. Those symptoms include:
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Keeping Your Blood Pressure Healthy
Making some simple tweaks to your lifestyle can reduce your chances of high blood pressure and CKD, and can help lower your blood pressure if its already too high. The key changes to make include:
- reducing your salt intake
- having a healthy, balanced diet with lots of fruit, vegetables and whole grains
- losing weight if you need to
- staying active most days of the week
- drinking alcohol in moderation only no more than 14 units a week.
Bmi Insulin Resistance And Urinary Ph
The rising incidence of nephrolithiasis in overweight western populations may, in part, be due to an increasing number of uric acid stone formers. There is increasing evidence that higher BMI and insulin resistance may be etiologic in uric acid nephrolithiasis.,, A large retrospective analysis of 4,883 stone clinic patients revealed a stepwise decrease in urinary pH with increasing body weight that withstood adjustment for age and creatinine. An analysis of patients on diets restricted in calcium, sodium, and oxalate confirmed this trend. Data regarding the types of kidney stones that these patients developed were not reported. However, since low urine pH is a feature of uric acid nephrolithiasis, it is likely that a large portion of the more obese patients suffer from uric acid stones. This supposition is supported by recent analyses showing that in fact, excluding patients with diabetes, higher BMI was associated with more uric acid stones. In one university stone center, 63% of stones in obese patients were composed of uric acid compared to 11% in the non-obese patients.
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Questions To Ask Your Doctor About Ckd
If you have high blood pressure or diabetes, its important to start or continue a dialogue with your doctor about your risk for CKD. Here are some questions you may want to ask, depending on your current kidney disease status.
1. Am I at risk for kidney damage if I have high blood pressure?
High blood pressure can damage blood vessels in your kidneys. If youve had uncontrolled high blood pressure for some time, theres a good chance youre at an elevated risk for CKD and may benefit from kidney function screening.
2. Am I at risk for kidney damage if I have diabetes?
Diabetes is the leading cause of CKD. Depending on how well controlled your blood sugar levels have been, you may have an increased risk of kidney damage if you have type 1 or type 2 diabetes. Talk to your doctor about ways to keep your kidneys healthy and whether you should get tested for CKD.
3. Should I have my kidney function tested?
A common test for kidney function measures blood levels of creatinine a normal waste product from muscle breakdown and uses this number along with other data to calculate an estimated glomerular filtration rate . Other tests to screen for and evaluate kidney disease look at levels of protein and blood in urine.
4. Do I have CKD?
5. What is my kidney function number?
Knowing your kidney function level and the stage of your CKD can help you and your doctor evaluate whether your current treatment strategy is working as well as it could.
6. Do I have protein in my urine?