Hypertension or High Blood Pressure

The kidneys are responsible for filtering excess fluid and waste from your blood. To do their job, they depend on healthy blood vessels. When the blood pressure is high, it damages the vessels in the kidneys, specifically the vessels in the nephrons or filters.  When the nephrons or filters become damaged they will not filter out the waste nor do they get the nutrients or oxygen they need to function properly.

As a result, your kidneys can become permanently damaged. Untreated high blood pressure can eventually lead to irreversible kidney damage, and high blood pressure which  is the second leading cause of chronic kidney disease.

Additionally, healthy kidneys produce a hormone necessary for controlling blood pressure. When kidneys are failing, they can’t produce this hormone, resulting in a continuous cycle of medical distress worsening the blood pressure.

High blood pressure can not only cause kidney disease but kidney disease can cause high blood pressure.

Your Nephrologist can determine the best course of treatment based on the severity of your blood pressure levels.

Life style changes can also benefit the blood pressure as well as slow the progression of kidney disease.

These life style changes may include:

• Healthy diet, including cutting back on salt
• Control your blood sugar if you have diabetes
• Control your cholesterol
• Quit smoking or using tobacco products including vaping
• Limit alcohol
• Stay at a healthy weight
• Be active most days of the week
• Take your medications as prescribed

High blood pressure may be controlled with a combination of life style changes; weight loss, exercise, changes in diet (including salt), stress reduction and smoking cessation. If these steps do not control your blood pressure then medications, and often a combination of medications is recommended.

Each type of blood pressure medication you take provides a different method or benefit for controlling your blood pressure and there by slowing the progression of kidney disease.

Report any side effects to your doctor so changes can be made as needed, keep current with your refills and avoid missing doses of your blood pressure medication.

Monitor your Blood Pressure at home

Your doctor may ask you to check your blood pressure at home with a digital blood pressure monitor. Many pharmacies and grocery stores have in-store monitors that you can use for free. You can also purchase a monitor from your local drug store, hospital, clinic or online.

Bring your blood pressure readings into your office visit for your Nephrologist so your progress can be monitored and changes can be made if needed.

When you check your blood pressure, your result will be two numbers.  Both numbers are important:

• The first (top) number is your systolic pressure. This is the pressure in your arteries and veins when your heart is beating and the pressure is at its highest.
• The second (bottom) number is your diastolic pressure. This is the pressure in your arteries and veins when your heart is between beats and the pressure is at its lowest.
• For most people a normal blood pressure is less than 120/80 mm Hg (120 over 80). This means that your systolic pressure should be 120 mm Hg or less and your diastolic pressure should be 80 mm Hg or less.
• Ask your doctor what your blood pressure should be and how often you should have it checked.

Eat healthy

What you eat and drink can change your blood pressure. Choose foods that are low in sodium (salt) and fat to help keep your blood pressure in a healthy range.

Learning how to read a label is key to staying in control of what you eat.

Try the following tips to get started:

Eat less sodium/salt

• Do not add salt to your food when cooking or eating.
• Try cooking with fresh herbs, lemon juice or spices.
• Mrs. Dash* is one good alternative, but do not use salt substitutes as they contain potassium.
• Choose fresh or frozen vegetables instead of canned. If you do use canned vegetables, use no salt added or rinse them with water before eating or cooking to help remove extra salt.
• Shop for items that say “reduced-sodium” or “low-sodium.” If you have kidney disease, but check that these items do not contain potassium instead of salt.
• Limit processed foods, such as frozen dinners and lunch meats.
• Limit fast food and salty snacks, such as chips, pretzels, and salted nuts.
• Limit foods that are pickled or preserved, such as pickles and olives.

Eat less fat

• Choose lean meats or fish. Remove the skin and trim the fat off your meats before you cook them.
• Bake, grill or broil your foods instead of frying them.
• Shop for fat-free or low-fat dairy products, salad dressing, and mayonnaise, but make sure they did not add salt to accomplish this.
• Try olive or canola oil instead of vegetable oil.
• Choose egg whites or egg substitute instead of whole eggs.

Stay Active

Try to exercise most days of the week but do check with your doctor before starting and starting small and building up to about 150 min/week is the advice from the AHA. There are alternative available for people who cannot walk or walk well, such as “chair yoga” and “Sit and be Fit”. Your doctor or nurse educator and help you with other alternatives based on your individual needs.

Stop using tobacco products

Talk to your doctor about possibility of medication aids that may be available to you to help you quit (lozenge, gum, patches, inhalers or pills).

Individual, group or telephone counseling, behavioral therapies in person, or online, even available on your mobile device.

Tobacco products increase your blood pressure and thereby progress kidney disease.

Women with chronic kidney disease (CKD) are at increased risk of having complications including irreversible worsening of renal function, and other complications in their pregnancy. Similarly, a woman with hypertension in pregnancy may be at risk for CKD.

Sometimes obstetricians or OB/GYN (a doctor who specializes in pregnancy, childbirth, and a woman’s reproductive system) will ask their patient to see a nephrologist or kidney doctor so they can coordinate the care and management of your high blood pressure and if needed manage your kidney disease to prevent complications for you and your baby.

Sometimes a nephrologist is called in after the pregnancy if the blood pressure does not return to the normal range to prevent kidney disease and other complications of high blood pressure.

Our nephrologist at San Antonio Kidney are experts in managing and treating high blood pressure associated with pregnancy and will collaborate with your obstetrician to prevent complications for you and your baby.