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Understanding Kidney Disease and High Blood Pressure: Symptoms, Causes, and Treatments

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on May 22nd, 2023.

Key Takeaways

  • High blood pressure damages kidney blood vessels over time, while damaged kidneys release hormones that further elevate blood pressure, creating a dangerous feedback loop that accelerates both conditions.

  • Target blood pressure for people with chronic kidney disease should be below 130/80 mmHg, compared to 140/90 mmHg for the general population, requiring more aggressive management.

  • ACE inhibitors and ARBs not only lower blood pressure but also reduce protein leakage from kidneys by up to 35%, making them first-line treatments even in patients with normal blood pressure.

  • African Americans are 3-4 times more likely to develop kidney failure from hypertension and typically need combination therapy with 2-3 blood pressure medications rather than single-drug treatment.

  • A reduction in estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m² for three months or protein in urine indicates chronic kidney disease requiring immediate intervention.

High blood pressure, also known as hypertension, is a leading cause of kidney disease and kidney failure (end-stage renal disease). On the other hand, kidney disease can also cause a type of high blood pressure called renal hypertension. It's essential to understand the connection between these two conditions and how to manage them effectively.

Symptoms of Kidney Disease

Kidney disease often develops without noticeable symptoms, making it difficult to detect in its early stages. However, some signs may indicate the presence of kidney disease, including:

  • High or worsening blood pressure

  • Decrease in the amount of urine or difficulty urinating

  • Edema (fluid retention), especially in the lower legs

  • A need to urinate more often, especially at night

Diagnosing Kidney Disease

To diagnose kidney disease, your doctor may perform certain laboratory tests that indicate whether your kidneys are eliminating waste products properly. These tests include serum creatinine and blood urea nitrogen; elevated levels of either can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.

Understanding Kidney Disease and High Blood Pressure: Symptoms, Causes, and Treatments

Risk Factors for Kidney Disease Caused by High Blood Pressure

While kidney disease caused by high blood pressure affects every group and race, certain groups are at higher risk, including:

  • African-Americans

  • Hispanic-Americans

  • Native Americans

  • Natives of Alaska

  • People with diabetes

  • People with a family history of high blood pressure and kidney disease

Preventing Kidney Disease

To prevent kidney damage from high blood pressure, it's crucial to take the following steps:

  1. Keep your blood pressure controlled and get it checked regularly

  2. Eat a proper diet

  3. Get moderate exercise, such as walking, for 30 minutes daily

  4. Take the medication your doctor prescribes

Treating Kidney Disease and Renal Hypertension

For patients with high blood pressure and kidney disease, the most important treatment is to control their blood pressure through lifestyle changes and medication. The most important blood pressure medications to treat renal hypertension include angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARBs).

Renal hypertension, a type of high blood pressure caused by kidney disease, is usually caused by a narrowing in the arteries that deliver blood to the kidney. This condition is called renal artery stenosis and is most often caused by atherosclerosis (hardening of the arteries). In some cases, procedures such as angioplasty, stenting, or surgery on the blood vessels of the kidney may help improve blood flow and control blood pressure.

It's essential to work closely with your healthcare provider to develop an individualized treatment plan that effectively manages your kidney disease and high blood pressure. By understanding the connection between these conditions and taking proactive steps to prevent and treat them, you can help protect your kidney health and overall well-being.

For more information on kidney disease and high blood pressure, visit:

The Bottom Line

This dangerous cycle progresses silently for years, making regular monitoring of both blood pressure and kidney function essential for early intervention. Aggressive blood pressure control with kidney-protective medications can slow progression and prevent dialysis in many cases. If you're noticing swelling, changes in urination, or have risk factors, Doctronic can help you understand your symptoms and next steps.

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