What is renal hypertension? – Ask ADC video

September 20, 2019

When you have high blood pressure, the first thing you think about is your brain and heart. The other most important vital organ which can be affected by high blood pressure is the kidney. I can actually control your blood pressure by different mechanisms. How it affects the blood pressure is fascinating. There is something called the renal sympathetic system. It is the nerve to the kidneys. It can cause a vasoconstriction, meaning a narrowing of the vessels supplying it to the kidneys. Whenever there is a defect in that system, it can lead to narrowing of the vessels, leading to high blood pressure. It also can cause a scarring of the kidney arteries which eventually can lead to high blood pressure. If you think about renal hypertension, many people do not know or have many symptoms. If the blood pressure is uncontrolled, we see many symptoms. They come in the form of headache, dizziness, chest pain, palpitations. But many times, for the vast range of blood pressure, you do not get any symptoms. It is usually the blood pressure monitor at home or at your physician’s office which tells you the blood pressure is really high and you need to control it. When you see a patient with hypertension, you do not know for sure whether they have renal hypertension or not. When you do the diagnosis or more testing, you learn they have hypertension because they have a kidney disease. Or they have hypertension because there is some blockage in the arteries supplying it to the kidney. We cannot change our environment many times. We cannot change our genes many times — we have had them since birth. What we can do is lifestyle modifications. Salt intake is key. There are people who are extremely salt sensitive. Their blood pressure really rises when they eat salt. Most of the people who see the nephrologist have extreme fear. They fear they have a kidney disease — they are labeled with a problem. Do they really need to be on dialysis the next day? Have they had this problem for a long time and it’s been underdiagnosed? Overdiagnosed? These people are asymptomatic. They have no symptoms. Sometimes they don’t understand why they have been referred to a kidney doctor to begin with. They are feeling fine. Their blood pressure is OK, their diabetes is under control. Blood tests show the kidney is not working very well. What does that mean? Many people come with this fear that they are going to be on dialysis the next day and that ius not true. There are many times patients have a kidney disease, but mild or moderate in range. It could be easily treated, prevented or at least halted at that time and avoid the progression of that kidney disease.. I think seeing a nephrologist in a timely manner has been shown that the progression of kidney disease slows down. There is also a longer time frame between their diagnosis and being on dialysis. []

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