Poorly treated hypertension can cause kidney failure

The relationship between hypertension and kidney health is an extremely important binomial, as hypertension can impair the health of the kidneys or kidneys to be responsible for raising blood pressure . Classically we say that the kidneys are victims of or blamed for high blood pressure.

Blood pressure is nothing more than a physical force through which the blood pumped through the heart? Walks? by a route (arteries) to carry the necessary supplies to the organs. When the pressure is increased (arterial hypertension), the force that the heart needs to pump to pump the blood is greater because the artery is less compliant, that is, the arteries offer greater resistance to the passage of blood. This force greater than "pushes" the blood flowing into the wall results in lesions in the wall of the arteries, and this lesion affects all arteries, large or small (arterioles).

This applies to the kidneys as well. Faced with elevated pressure (arterial hypertension), the renal arteries and arterioles are affected, resulting in progressive loss of excretory function of the organ. In other words, as renal vessels are damaged, there are changes in the ability to excrete surplus volume that should be eliminated, as well as some substances (metabolism products). Therefore, if the kidneys fail to eliminate excess volume, this in turn may increase blood pressure even more. It is important to stress that renal impairment caused by hypertension occurs slowly and insidiously, so do not accompanied by symptoms or signs indicating that a kidney problem is ongoing.

In addition, some patient populations are at a higher risk of developing chronic kidney disease, and among them, in addition to hypertension itself, are the elderly, the obese (BMI) > 30 kg / m2) and diabetics (type 1 and type 2).

Do not wait for symptoms or signs that may suggest changes in the kidneys, because in this circumstance kidney damage may have already occurred

lack of control of blood pressure, diabetes, cholesterol levels and smoking contribute not only to worsening kidney health, but also to a worse course of chronic kidney disease.

How then could we track the function to see if there is a problem? The initial tests used for renal function screening are creatinine dosage and urinalysis type 1.

Creatinine is a product of the breakdown of muscle cells, produced at a nearly constant rate. When the kidneys are functioning normally, creatinine is withdrawn from the blood and eliminated by urine, however, when renal function is decreased, creatinine is not excreted properly and its levels increase in the blood, indicating that there is a problem in the function

One way to estimate kidney function is by calculating the estimated glomerular filtration rate (GFR). This estimate is based on the formulas proposed by the international guidelines on nephrology. Thus, a person who, irrespective of the cause, has an EGFR <60ml / min / 1.73mile for at least three consecutive months.

Another type to evaluate is the type 1 urine test. Minimally, the test will give us indications of protein loss (albumin), which is also indicative of impaired renal function, since there is usually no loss of protein (albumin) in the urine. If the test shows a more significant loss, we can use other tests to better investigate the amount of protein (albumin) lost in the 24 hours and also evaluate the kidneys through imaging tests such as ultrasound.In summary, hypertension can damage the kidneys, and consequently compromise renal health without being aware of this situation, and thus, it is important to determine the creatinine and to perform a urine test in all hypertensive patients, at least one once a year, so that the evolution of this disease can be detected and / or monitored, which, as often said, is silent.

Blood pressure control is essential to prevent the development of kidney disease. Thus, for hypertensive and / or diabetic patients with no evidence of renal disease, the recommended target is below 140/90 mmHg and for diabetic patients with albuminuria is less than or equal to 130/80 mmHg.

In addition, the adoption of measures for lifestyle modification such as, avoiding overweight or obesity, reducing the amount of salt in the diet, ingesting less than 2g sodium / day (5g / day of cooking salt), quitting smoking, avoiding fatty foods and having activity As can be seen, renal health associated with hypertension requires simple measures of traceability, lifestyle modifications, and continuous treatment of hypertension in patients with hypertension. achieve and maintain adequate blood pressure control. Do not wait for the appearance of symptoms or signs that may suggest this change, because in this circumstance, possibly kidney damage has already settled and the next step will be to prevent it from progressing. At birth we have an already determined number of functional structures in the kidneys, which once lost will not be recovered.

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