Low Blood Pressure And Kidneys

How Kidneys Influence Blood Pressure

The blood pressure in your body depends upon the following conditions:

• The force of contraction of the heart related to how much the heart muscle gets stretched by the incoming blood.
• The degree to which the arteries and arterioles constrict increases the resistance to blood flow, thus requiring a higher blood pressure.
• The circulating blood volume the higher the circulating blood volume, the more the heart muscle gets stretched by the incoming blood.

The kidney influences blood pressure by:

• Causing the arteries and veins to constrict
• Increasing the circulating blood volume

Specialized cells are located in a portion of the distal tubule located near and in the wall of the afferent arteriole. The distal tubule cells sense the Na in the filtrate, and the arterial cells sense the blood pressure. When the blood pressure drops, the amount of filtered Na also drops. The juxtaglomerular cells sense the drop in blood pressure and the decrease in Na is relayed to them by the macula densa cells. The juxtaglomerular cells then release an enzyme called renin. Renin converts angiotensinogen into angiotensin I. Angiotensin I is then converted to angiotensin II by an angiotensin-converting enzyme , which is found mainly in the lungs. Angiotensin II causes blood vessels to contract the increased blood vessel constrictions elevate the blood pressure.

As you can see, the kidneys perform many functions that are important to your body:

Is Low Blood Pressure Bad For Your Health

Lower blood pressure is associated with a lower risk of conditions like heart disease, stroke, and kidney disease. Those who exercise regularly, athletes, non-smokers, and those who maintain an optimal body weight experience lower blood pressures. Lower blood pressure is a good thing as long as it doesn’t cause symptoms that could damage organs and tissues of the body.

Plan Ahead To Manage Pain Flu Or Other Illness

Almost everyone gets sick once in a while. Your doctor or pharmacist can help you plan ahead to keep your kidneys safe until you get well. Prepare in advance so you know what to do if you have pain or a fever, diarrhea, nausea, or vomiting, which can lead to dehydration.

Before you get sick, ask your health care provider or pharmacist the following questions

• If I get sick, are there medicines I should not take while Im sick?
• If I need to stop medicines when Im sick, when can I restart them?
• What can I take or do to relieve a headache or other pain?
• What can I take to relieve a fever?
• If I have diarrhea or am vomiting, do I need to change how or when I take my blood pressure medicine?

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Artificial Sweeteners May Alter Blood Sugar Response

Many people with diabetes reach for diet drinks as a substitute for regular soda or juice because they assume that sugar-free beverages wont raise their blood sugar. But a review published in January 2021 in Frontiers in Nutrition suggested that artificial sweeteners may not be completely neutral after all, and may contribute to impaired glucose homeostasis.

But the research isnt definitive most government and medical institutions maintain that most artificial sweeteners have no effect on blood sugar. So what could be going on? Mayo Clinic suggests that people can experience a rebound effect when consuming artificial sugars. They consider the sugar-free food healthy, so end up consuming excessive amounts or eating other carb-filled foods because they think the diet drink lets them afford it. The clinic also notes that some noncaloric sweeteners can cause diarrhea, which can contribute to dehydration.

If you drink a lot of diet soda then you might want to cut back and see if it has an impact on your blood glucose, says Patty Bonsignore, RN, CDCES, a nurse educator at the Joslin Diabetes Center in Boston. Keep things sugar-free by turning to water or seltzer as opposed to regular soda or juice.

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Keep Your Kidneys Healthy Control Your Blood Pressure

Adults with high blood pressure, diabetes, or both, have a higher risk of developing chronic kidney disease than those without these diseases.

CKD is a condition in which the kidneys are damaged or cannot filter blood as well as healthy kidneys for 3 months or longer. Because of this, excess fluid and waste from the blood remain in the body and may cause other health problems.The good news is that there is a lot you can do to prevent kidney problems, including keeping your blood pressure and blood sugar under control.

In addition to managing blood pressure and blood sugar levels, managing cholesterol levels is very important because these are all risk factors for heart disease and stroke.

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Tips For Drinking More Water

If you donât like the taste of plain water, there are several easy hacks you can try to increase your fluid intake, such as:

• Sip carbonated or sparkling water instead of plain. Many naturally flavored sparkling waters provide a bit of fruity flavor without added sugar or artificial sweeteners.
• Add sliced fruit, such as lemons, limes, cucumbers, or strawberries to your water.
• When fresh mint is available, infuse water with the leaves and stems for a hint of mint refreshment.
• Cinnamon< sup> 9< /sup> and powdered probiotics< sup> 10< /sup> may also help with glucose regulation. Make a mug of herbal or black tea and drop in a cinnamon stick, or whisk in powdered probiotics into any tea or coffee drink. Read more about the benefits of cinnamon here.
• Tea and coffee count toward your total daily water intake. Just keep an eye on your caffeine intake, as some people can experience increased blood sugar from caffeine.
• Fruits and vegetables contain water as well, which also counts toward your total daily intake. Try low-glycemic produce such as celery, lettuce, cucumbers, watercress, zucchini, strawberries, tomatoes, bell peppers, cauliflower, and cabbage.

Try drinking more water before, during, and after meals, and adding in more water-packed fruits and veggies to your diet.

Regulating blood sugar can be done at home with a few tweaks to your daily habits.

It starts with adapting a mindset of healthy eating, drinking, and living. Cheers!

Dehydration And High Blood Pressure

High blood pressure is when you have a systolic reading of 140 mm Hg or higher, or a diastolic reading of 90 mm Hg or higher.

Dehydration has been linked to high blood pressure. However, research into this topic is limited. Additional work is needed to investigate the connection.

Although more research is needed, its still worth noting that dehydration can lead to an increase in blood pressure due to the action of a hormone called vasopressin.

Vasopressin is secreted when theres a high amount of solutes in your blood, or when your blood volume is low. Both of these things can happen when you lose too much fluid.

In response, when youre dehydrated, your kidneys reabsorb water as opposed to passing it in urine. High concentrations of vasopressin can also cause your blood vessels to constrict. This can lead to an increase in blood pressure.

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What Is High Blood Pressure And How Does It Affect The Kidneys

The National Institute of Diabetes and Digestive and Kidney Diseases defines blood pressure as an increase in the amount of force that blood puts on the vessels as it moves throughout the body.

Over time, blood pressure can damage and weaken blood vessels throughout the body, including those in the kidneys. When the blood vessels in the kidneys become damaged, it can affect how well the kidneys function.

When the kidneys do not function properly, it can lead to excess fluid and waste buildup in the bloodstream. This in turn can cause high blood pressure, resulting in further damage to the kidneys.

Over time, a person can develop kidney failure.

• changes in urine volume
• generalized numbness or itchiness or darkened or dry skin

If a person is taking multiple medications to manage their blood pressure, and these are not having an effect, doctors may suspect that renovascular hypertension could be the cause.

Any condition that affects blood flow to the kidneys can lead to renovascular hypertension.

The most common causes of renovascular hypertension are forms of renal artery stenosis. Atherosclerosis, which is the buildup of plaque in the arteries, is behind 90% of cases. Fibromuscular dysplasia, which is a condition that causes the narrowing of the arteries, is behind 9% of cases.

Other potential causes

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What Other Conditions Cause Low Blood Pressure

Sometimes, a bacterial or fungal infection from another part of the body enters the blood. This type of infection is called septicemia. It’s potentially life-threatening and may cause severe low blood pressure called septic shock that may damage organs. Septicemia may result from diverticulitis, pneumonia, urinary tract infection, or other infections.

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Which Beverages Hydrate The Body And Which Dehydrate

Some beverages are better than others at preventing dehydration. Water is all you need if youre planning to be active in a low or moderate intensity activity, such as walking for only an hour or less. If you plan to exercise longer than that, or if you anticipate being out in the sun for more than a few hours, you may want to hydrate with some kind of sports drink. These replace not only fluid, but also electrolytes like sodium and potassium, which are lost through sweating. Too much or too little sodium and potassium in the body can cause trouble. Muscle cramping may be due to a deficiency of electrolytes.

Beverages containing alcohol or caffeine arent recommended for optimal hydration. These fluids tend to pull water from the body and promote dehydration. Fruit juice and fruit drinks may have too many carbohydrates, too little sodium and they may upset your stomach.

Adequate hydration will keep your summer activities safer and much more enjoyable. Keep an extra pitcher of water in the refrigerator and add fresh lemons, limes, cucumber or mint for a dash of flavor.

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Summary Of All Study Subjects

Overall, 28,258 subjects with 66% male and at age of 69.4±6.2 years were studied. The prevalence of hypertension, hypotension, obesity, hyperlipidemia and diabetes were 68.2%, 4.4%, 10.4%, 41.2% and 47.6%, respectively. Males were more likely to have hypertension than females but females were more likely to have hypotension than males . SBP was as high in women as in men whereas women had lower DBP and larger PBP than men . Estimated GFR by MDRD formula was higher than that calculated by CKD-EPI equation . There was a mean difference of 3.5ml/min/1.73m2 between MDRD and CKD-EPI eGFR when their average was less than 98ml/min/1.73m2 but the difference became larger and larger when their average value was more than 98ml/min/1.73m2. Many extreme high values of GFR could be easily obtained by MDRD equation .

Comparison between MDRD formula and CKD-EPI equation in the elderly. A: Bland-Altman plot of MDRD and CDK-EPI eGFR B: Boxchart of MDRD and CDK-EPI eGFR. â represents extreme values, â represents outliers.

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When To See A Specialist

If youre at risk of kidney disease due to high blood pressure, your primary care doctor may recommend annual testing. You may also be referred to a nephrologist, a doctor who specializes in kidney disorders.

At Temple, our nephrologists will work with you to find the best way to maintain kidney function. And if necessary, guide you through a range of treatment options.

Can Bp Go Too Low In Kidney Disease Patients

Jeffrey S. Berns, MD Raymond R. Townsend, MD

Jeffrey S. Berns, MD: Hello. This is Jeffrey Berns, Editor-in-Chief of Medscape Nephrology.

This has been an interesting year for hypertension, with several papers coming out and perhaps giving us confusing information about what the best targets are for blood pressure control. It began, to some extent, with the Joint National Committee 8 report that was in JAMA, followed by subsequent discussion about the best targets for blood pressure.

A recent retrospective study was published in the Journal of the American College of Cardiology. This analysis included about 400,000 patients from Kaiser Permanente of Southern California and suggested that there was a J- or U-shaped curve for systolic and diastolic blood pressure and mortality outcomes in end-stage renal disease. More recently, a study using Veterans Affairs data retrospectively compared strict vs conventional blood pressure control in patients with chronic kidney disease .

In this particular study, Kovesdy and colleagues organized data from more than 650,000 patients in the VA who had a diagnosis of CKD, either because of a glomerular filtration rate less than 60 mL/min/1.73 m2 or the presence of proteinuria. They then focused on the cohort that had CKD diagnosed by virtue of their low GFR.

Dr. Berns: Men made up almost all those studied, of course.

Dr. Berns: Heart failure or something.

Dr. Townsend: Correct. That is safe to say.

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How Is Low Blood Pressure Treated

Anyone who experiences low blood pressure or believes he or she may be experiencing low blood pressure should be evaluated by a physician. Even if low blood pressure does not cause any symptoms, the patient should still be evaluated. Treatment for low blood pressure varies depending on the cause. If the patient is already taking medication to treat high blood pressure, the dose of the medication may need to be adjusted. If fluid loss from diarrhea or vomiting is causing a drop in blood pressure, IV fluids may be administered to bring blood pressure back up to normal.

How Often Should I See My Doctor

• Your CKD team will outline a treatment plan for you after you are diagnosed. Most patients come to the clinic 1 or 2 times per year. Well ask you to come in more often if:

• You start a new medicine or we change your medicine dose.

• Your kidney function is getting worse.

• Your blood pressure is not controlled.

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Low Bp May Be Fatal In Ckd

This article is a collaboration between MedPage Today and:

Patients with chronic kidney disease , including those with diabetes, who were not on dialysis were more likely to die when blood pressure was too low, even if only on the diastolic measure, a veterans cohort showed.

The relationship between systolic blood pressure and mortality followed a U-shaped curve that bottomed out at 130 to 159 mm Hg, while the J-shaped curve for diastolic pressure hit its optimal point at 70 to 89 mm Hg, Csaba P. Kovesdy, MD, of the VA Medical Center in Memphis, Tenn., and colleagues found.

Action Points

• This large VA-based study demonstrated that blood pressure, either too high or too low, was associated with increased risk of all-cause mortality in patients with CKD.
• Be aware that, due to the observational nature of the study, causality can not be determined. Patients with low blood pressure may have other comorbidities that predispose to adverse outcomes.

Considered together, coming in a little high on systolic blood pressure appeared to be less risky than going too low with diastolic pressure, the researchers reported in the Aug. 20 issue of the Annals of Internal Medicine.

The likelihood of death for patients with an optimal systolic pressure of 130 to 139 mm Hg rose the lower the diastolic pressure went below 70 mm Hg. Adjusted hazard ratios were :

• 1.09 at 60 to 69 mm Hg
• 1.14 for 50 to 59 mm Hg
• 1.37 for 40 to 49 mm Hg
• 1.91 for anything below 40 mm Hg

Disclosures

Can Dehydration Affect Type 2 Diabetes Risk

Although dehydration can lead to serious health issues, not much research has looked at whether chronic dehydration and the associated higher blood sugar may increase the risk of prediabetes and full-blown type 2 diabetes.

There have been a variety of things dehydration has been suggested to contribute to, but not diabetes, Rizza says.

But there may be a connection, says Anna Simos, MPH, a certified diabetes care and education specialist with the Stanford Health Care Diabetes Education and Prevention Program in Palo Alto, California. Indeed, according to a previous study, which monitored healthy adults over nine years, peoples self-reported water intake was inversely associated with a risk of developing high blood sugar. This means that people who reported drinking less than ½ a liter of water per day were more at risk of elevated blood sugar than people who reported more than 1 liter.

Scientists theorize that dehydration can lead to an increase in the hormone vasopressin, which prompts the kidneys to retain water and the liver to produce blood sugar, potentially affecting the bodys ability to regulate insulin over time.

The bottom line: More research is needed to fully understand the relationship between dehydration and diabetes, but hydration likely keeps blood glucose levels a little more stable, Simos says.

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