High blood pressure means that the force of blood

against the walls of your blood vessels is too high.

Your heart has to work harder to pump blood through

the arteries and to the rest of your body. High blood

pressure also damages blood vessels throughout the

body, narrowing them and making their walls thicker,

less elastic, and “harder” (as in hardening of the arteries,

or atherosclerosis).

High blood pressure can injure the blood vessels in

your kidneys so that they aren’t able to properly filter

your blood and remove waste and extra fluids from

your body. When the waste and fluids are not removed,

they build up in your blood and harm your body.

Kidney disease can take many years to develop. At

first, small amounts of blood proteins (albumin) begin

to leak into the urine. At this point, the kidneys are

still filtering body waste and fluids. But as kidney disease

worsens, more albumin leaks into the urine, and

the kidneys’ filtering function begins to decrease.

When kidney damage grows severe enough, the kidneys

stop working. This is called kidney failure. People

with kidney failure need a transplant or must undergo

dialysis (a substitute for some filtering normally done

by healthy kidneys).

You can take steps to prevent the development of

kidney disease, starting with being tested for high

blood pressure.

About 60% to 65% of people with diabetes also have

high blood pressure. High blood pressure is a major factor

in the development of kidney problems in people with

diabetes. The effects of both diabetes and high blood

pressure on the kidneys are a dangerous combination.

Diabetes is the most common cause of kidney failure,

responsible for more than 40% of new cases. More than

100,000 Americans are living with kidney failure as a

result of diabetes. If you have diabetes, it is doubly important

to have your blood pressure checked frequently. Then,

if high blood pressure develops, it will be detected and

treated early, regardless of how mild it is.

You are at risk for kidney disease or kidney

failure if you have

African-Americans are six times more likely than

whites to develop high blood pressure-related kidney

Ask your doctor about being tested for kidney disease

if you’re at risk. Blood tests can show how well

your kidneys are functioning. You can also be tested to

determine the level of protein in your urine (proteinuria).

People with diabetes should have yearly urine tests.

If you have diabetes, talk with your doctor about

diet choices and physical activities that will help keep

your blood sugar as close to normal as possible and

keep your blood pressure low. It is especially important

to limit dietary sodium (salt) if you have kidney

disease. Losing excess weight, getting 30 or more

minutes of physical activity on most days, quitting

smoking, and limiting alcohol intake are other important

lifestyle changes that will help lower blood pressure

and keep your kidneys healthy, whether you have

diabetes or not.

There are also blood pressure medications that can

treat high blood pressure and slow the progression of

kidney disease. Doctors usually prescribe angiotensinconverting

enzyme (ACE) inhibitors and angiotensin

receptor blockers (ARBs), as well as diuretics (“water

pills”). Many people take two or more drugs, including

beta blockers and calcium channel blockers, to control

blood pressure and protect the kidneys.

Protect your kidneys by controlling blood pressure

and diabetes and by talking with your doctor about

getting tested. If you do have kidney disease, you can

take steps to keep your kidneys working and enjoy a

healthier, longer life.

with diabetes should keep their

prevent kidney damage.

to develop high blood pressure as those

without diabetes.

causes of kidney failure. Every year, high

blood pressure causes 15,000 new cases

of kidney failure in the United States.

from high blood pressure, but African-

Americans, American Indians, and Alaskan

natives are more likely than whites to have

high blood pressure and to develop kidney

problems from it–even when their blood

pressure is only mildly elevated.

activity on most days

weight

prescribes

your diet

without making you feel sick. And kidney disease is similar; in fact, even when your kidneys

are working at only half their normal ability, you may not feel any symptoms. The kidneys,

which filter the blood and remove waste and extra fluids, can almost stop working

before there are signs of kidney disease. Like high blood pressure, kidney

disease can be found only with medical tests given by a doctor.

The connection between high blood pressure and kidney disease

doesn’t end there. High blood pressure is not only a major cause of kidney

disease and kidney failure, but also can be a result of kidney disease. In a

dangerous cycle, as kidney disease worsens, blood pressure gets higher.

P&T Community website. Available at:

http://www.ptcommunity.com/. Accessed on June 27, 2005.

National Kidney and Urologic Diseases Information

Clearinghouse (NKUDIC) website. NIH Publication

No. 03-4572 July 2003. Available at:

http://kidney.niddk.nih.gov/. Accessed on June 27, 2005.

Source: Diabetes In Control

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