Hypertension hastens kidney failure (by JANICE TAI)

by by JANICE TAI in the Mind Your Body of the Straits Times dated 17 September 2009, Thursday.

As the kidney helps to control blood pressure, a diseased one will have trouble doing so for a hypertensive person. JANICE TAI reports
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Hypertension or high blood pressure poses two immediate problems for kidney patients.

Hypertension will hasten or worsen kidney failure. It leads to faster progression towards end-stage kidney disease that will, in turn, require dialysis or kidney transplant, said Dr Titus Lau, a senior consultant at the division of nephrology at the National University Hospital.

Hypertension also causes an increased risk of developing cardiovascular disease.

Patients with kidney disease have a high incidence of cardiovascular disease and having hypertension adds to that risk, possibly resulting in heart attacks, sudden death, stroke and heart failure.

Dr Lau said that patients with kidney disease are more likely to develop hypertension because the kidney is the major organ that helps to maintain normal blood pressure.

When the kidney is diseased, its ability to control blood pressure is diminished.

Therefore, good blood pressure control will protect the kidney.

Dr Lau advised kidney patients to monitor their blood pressure each time they see a doctor. They could also buy a home monitoring device and measure their blood pressure at different times of the day.

Compliance with medication, a low-salt diet and regular exercise will contribute significantly to better blood pressure control.

Kidney patients should maintain their blood pressure below 130/80mmHg (millimetres of mercury). For other adults, maintaining a blood pressure of below 140/90mmHg is sufficient.

A common misconception is that too much blood pressure medication will harm the kidneys further. However, Dr Lau said that patients should trust their doctors to prescribe the appropriate medication that is safe.

Having kidney disease may not always lead to end-stage kidney failure which requires dialysis or transplant. So it is important for kidney patients to maintain good blood pressure control in order to maintain kidney health and overall health.