High blood pressure persists - check your kidneys

A situation often arises when a hypertensive patient notices that medications that normalize blood pressure have stopped working. But there was swelling, pain in the lower back and other reasons indicating kidney disease. This means that hypertensive nephropathy has arisen - kidney damage caused by vascular problems. In this condition, it is impossible to get rid of hypertension without the help of a urologist.

What is a renal vicious circle

In this situation, atherosclerosis, which causes hypertension, is the cause of poor blood supply to the kidneys. As a result, kidney tissue, which does not receive enough oxygen and nutrients, cannot fully perform its function.

The situation becomes critical if the patient has chronic kidney diseases - pyelonephritis, glomerulonephritis, urolithiasis, hydronephrosis (dilation of the renal collecting system). In this case, the unhealthy organ also finds itself without sufficient blood supply.

Urine filtration worsens, the amount of fluid in the body increases and, accordingly, blood pressure rises. Sick kidneys increase the production of the enzyme renin, which increases blood pressure.

The patient begins to take antihypertensive drugs, sometimes independently increasing the dosage. Such treatment is pointless - impaired kidney function will not allow blood pressure levels to drop to normal levels.

Set priorities

“The first thing I would like to talk about when answering the question about which indicator is more important is what blood pressure actually is and what the measured parameters indicate. Blood pressure (also called blood pressure) is the pressure that blood exerts on the walls of blood vessels. This parameter is one of the indicators of the vital functions of the body,” notes Maria Benevskaya.

When measuring blood pressure, as the cardiologist says, two types are determined: with each heartbeat, the blood pressure fluctuates between the highest, systolic (from the ancient Greek “compression”), and the lowest, diastolic (from the ancient Greek “rarefaction”) "), which are colloquially called upper and lower. Thus, the magnitude of the force acting on the vessels is determined by two parameters: upper (systolic) and lower (diastolic) pressure. Therefore, we cannot say that any of these parameters is more important. They both have their meaning.

“Everyone knows that the normal blood pressure of a healthy person (systolic/diastolic) is 120 and 80 mmHg. Art., but we must also remember that normal boundaries change depending on age and existing diseases. The difference between systolic blood pressure and diastolic blood pressure is called pulse pressure and is normally 30-50 mmHg. Art.,” the specialist emphasizes.

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Symptoms indicating kidney pressure

Weakening the effect of antihypertensive drugs . The medications that patients previously took for blood pressure stop working.
Nocturia is an increase in urine production at night. Sometimes patients get up to go to the toilet several times a night. Lack of proper sleep leads to headaches and heart problems.
Swelling that appears in the morning . At the beginning of the disease, swelling decreases during the day or even disappears completely. When kidney function deteriorates, this condition persists permanently. Renal edema is loose, so after pressing with a finger, a hole remains that does not disappear for a long time. Fluid excretion worsens after consuming salty, smoked and alcoholic foods.
Decreased amount of urine excreted . Patients feel a false urge that is not accompanied by urination.

If measures are not taken, renal failure will develop, which will “tie” the patient to a hemodialysis machine (artificial kidney).

Clinical picture

Renal arterial hypertension is characterized by a significant increase in blood pressure and accompanying conditions. Patients complain of the following ailments:

constant thirst;
general weakness;
lower back pain;
frequent urination;
increased body temperature;
pain when urinating.

In addition, the pathology may be accompanied by discomfort characteristic of high blood pressure: headache, shortness of breath, vomiting, nausea, dizziness and blurred vision.

It is important to understand that the symptoms of renal hypertension require medical attention. Treatment based on recommendations from friends or advice from the Internet can lead to rapid progression of the disease. A serious deterioration in kidney function will be noticeable within a few months. Such conditions are very difficult to treat with medication, so timely consultation with a doctor is the key to successful therapy.

What tests are prescribed for renal pressure?

General or extended blood test - tests reveal an acceleration of ESR, a decrease in hemoglobin. With concomitant inflammatory processes, the concentration of leukocytes increases.
Blood biochemistry shows a decrease in total protein, an increase in the levels of lipids, nitrogen, urea and creatinine.
Urinalysis - protein is determined, the concentration of which can rise to 1-3 g/l. The presence of red blood cells and white blood cells is caused by concomitant renal pathologies.
Kidney tests . To determine nocturia - nocturnal urination - a Zimnitsky test is prescribed, in which urine is collected every 3 hours during the day in a separate jar. In the laboratory, the volume of urine released and its composition are determined. With hypertensive nephropathy, an increase in nighttime urine production and a decrease in its density are detected.
The Rehberg test is a comprehensive study that allows you to determine the functioning of the glomeruli that filter urine using biochemical analysis and urine analysis. With kidney damage accompanied by high blood pressure, the glomerular filtration rate is significantly less than the lower limit of normal.
Ultrasound of the kidneys and pelvic organs , showing the condition of the urinary system. A decrease in the size of the kidneys and their deformation indicate an advanced process. Often concomitant pathologies of the bladder and urethra are detected, which also need to be treated.

Importance of indicators

So is it possible to conclude which of these indicators is more important? “As we have already figured out, each of these parameters has its own meaning, so they are both important. Currently, it is also customary to distinguish between isolated systolic hypertension, when only the upper pressure is increased, and isolated diastolic hypertension when only the lower pressure is increased. Each of these forms has its own prognostic significance and some features in treatment, so it is necessary to approach the identification and correction of these types of hypertension with equal attention,” notes Maria Benevskaya.

Treatment

To reduce renal pressure the following are prescribed:

Nephroprotectors are medications that protect kidney tissue.
Substances that block the kidneys from producing enzymes that increase blood pressure.
Medicines that improve blood supply to kidney cells - nephrons.
Decongestants.
General restorative medications.
Means aimed at treating concomitant pathologies .
Diet therapy with the exclusion of salty, smoked, fatty, spicy, alcohol.

If you suspect kidney damage and increased blood pressure caused by renal pathologies, you should contact a urologist at the Raduga clinic to check the functioning of the urinary system.

Causes of pathology

Increased pressure is usually associated with occlusion or stenosis of the renal artery. Against the background of pathological processes, the lumen of the vessel narrows, which leads to an increase in blood pressure. The cause of the development of this condition may be pyelonephritis, glomerulonephritis, amyloidosis, hydronephrosis, polycystic kidney disease.

The development of the disease is facilitated by systemic chronic diseases: diabetes mellitus, tuberculosis, fibromuscular dysplasia. The condition is observed with nephropathy in pregnant women.

Diagnostics

Diagnosis is carried out comprehensively, since there are no characteristic complaints from the patient. To make a correct diagnosis, the doctor must carefully evaluate the clinical picture, how long ago symptoms appeared, and the results of laboratory and instrumental studies.

The patient is prescribed:

Analysis of urine. Makes it possible to evaluate kidney function and identify functional disorders.
Ultrasound of the kidneys. Necessary to identify structural abnormalities of the organ.
Contrast radiography. Clearly shows the structure of the kidney and the presence of pathological inclusions.
Angiography. Provides broad information about the condition of the vessels, the width of their lumen, the presence of blood clots, atherosclerotic plaques and other inclusions, allowing one to assess the size and functionality of the arteries.
MRI. Appointed for a detailed examination of the structure and functioning of the organ.

In parallel, the doctor can give a referral to a cardiologist to rule out cardiac causes of increased blood pressure. It is impossible to cure hypertension without detailed diagnostics. Only drugs whose mechanism of action is aimed at eliminating the main problem will help lower blood pressure.

Attention to the gap

Of course, as experts note, it is also necessary to look at the gap between these parameters. “I repeat that the normal difference between upper and lower pressure is from 30 to 50 mm Hg. Art. All values that do not fit within these limits may indicate the presence of pathology, and this is already a reason to undergo additional examination. Although at the same time this may be due to the individual characteristics of the body and physiological conditions. But in any case, it’s better to see a doctor so as not to miss the disease,” notes Maria Benevskaya.

So, for example, the specialist emphasizes, a small difference may indicate:

the presence of atherosclerosis of the aorta (deposition of cholesterol in the largest vessel);
damage to the kidney vessels;
aortic aneurysm (pathological expansion of a separate section of the aorta with the possibility of rupture or dissection of the walls due to excessive load);
anemia (decreased hemoglobin levels in the blood) and many other conditions.

“An increase in the difference may be a consequence of osteochondrosis of the cervical spine, aggravated by a malnutrition of the brain (most often vertebrobasilar insufficiency). Diseases of the musculoskeletal system lead to weakening of cerebral blood flow. Hence the problems with upper and lower pressure in general,” notes the cardiologist.

Also, as Maria Benevskaya says, various endocrine diseases can lead to changes in pulse pressure. And this is not the entire range of pathologies that affect this parameter. A change in this indicator can be a “bell” to pay attention to your health.

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Forecast

With timely and properly selected treatment, the prognosis is favorable.

It worsens in the case of rapid progression of the renovascular form of the disease and in the absence of adequate treatment of any form, since irreversible changes occur in the renal tissue.

With an advanced parenchymal form and bilateral kidney damage, the prognosis is unfavorable, which becomes conditionally favorable after a kidney transplant.

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Preventive recommendations

To prevent increased pressure, you should follow some rules:

Constantly monitor your blood pressure, so you need to have a tonometer at home.
If symptoms of hypertension appear, consult a doctor immediately.
Do not take any medications unless prescribed by a doctor.
Control your weight and prevent obesity.
Reduce salt intake.
Do not drink alcohol or smoke.
Engage in moderate physical activity.
Avoid eating foods that can increase blood pressure levels.

Kidney pressure is considered a serious pathology that requires mandatory treatment. If timely measures are not taken, the condition will become chronic and can lead to irreversible complications. Therefore, even with minor symptoms of hypertension and a stable increase in blood pressure, you should immediately contact a specialist for a detailed examination.

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Effective treatments

The treatment regimen for nephrogenic hypertension in each case is individual. But there are general principles in the fight against pathology. The goal of therapy is to reduce blood pressure and eliminate factors for the development of hypertension. In order for the treatment result to be positive, the intervention of a therapist and urologist is necessary.

Therapy involves taking drugs to treat the causative disease and drugs that reduce the production of renin and reduce blood pressure. In some cases, surgery is required to eliminate the underlying disease. If there are bacterial kidney infections, antibiotics are prescribed.

Drug therapy

To reduce blood pressure, antihypertensive drugs are prescribed.

ACE inhibitors:

Enalapril,
Captopril,
Ramipril.

Important! If the patient has only 1 functioning kidney, the above medications cannot be used.

Angiotensin receptor blockers:

Kandensartan,
Losartan.

Calcium antagonists:

Felodipin,
Normodipin,
Amlodipine.

Typically, 4-5 drugs are used to combat renal pressure.

Surgery

If conservative therapy is ineffective, surgical treatment methods are used:

angioplasty,
stenting,
shunting.

Folk remedies and recipes

Non-traditional methods help to effectively reduce blood pressure. Use is possible only in combination with the main treatment, since folk remedies do not eliminate the cause of hypertension.

Effective for renal hypertension:

Grind yarrow, nettle, buckthorn bark in equal proportions and mix. Pour 1 spoon of the mixture into a glass of boiled water and leave for half an hour. Add some golden mustache juice. Drink 100 ml daily before bed.
Prepare a mixture of calamus root, bearberry, marshmallow and elecampane. Fill with water at about 90°C. Leave in a hermetically sealed container for 12 hours (preferably in a thermos). Take ½ glass of infusion for 14 days before meals.
Pour 3 tablespoons of crushed red grape leaves into 1 liter of boiling water. Leave for 3 hours. Drink 100 ml throughout the day before meals.

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Follow the link https://elesto.ru/bolezni/simptomy/pochechnaya-kolika.html and learn about the signs of renal colic and the rules for providing first aid.

Diet and lifestyle

Regardless of what caused the increase in blood pressure, the patient must adhere to a diet. You will have to exclude from the diet:

roast,
peppery and spicy,
spices,
coffee,
alcohol,
limit salt.

For renal hypertension, the following are useful for the body:

seaweed,
fish and fish oil,
vegetable juices (celery, cilantro, parsley),
berries (cranberries, lingonberries).

It is necessary to avoid increased physical activity (they increase vascular tone), as well as stress and anxiety. But doing exercises in the morning is useful. You can't lift weights. It is recommended to undergo a course of sanatorium-resort treatment 1-2 times a year in an area with coniferous and forest air.

Therapeutic strategy

Treatment of renal hypertension, the symptoms of which are similar to hypertension, aims to normalize blood pressure and slow the progression of renal failure, thereby improving the patient’s well-being and increasing life expectancy. Newly diagnosed nephrogenic disease or suspicion of it is a direct indication for hospitalization to clarify the etiological factor of high blood pressure.

Drug treatment

Pharmacotherapy should be selected exclusively by a doctor. Medicines are needed to bring blood pressure back to normal and improve the functional state of the kidneys. Even taking into account the fact that traditional antihypertensive drugs are used to treat pathology, without consulting a nephrologist, taking them with a high degree of probability will not have the desired therapeutic effect. The standard treatment regimen for hypertension of renal origin includes the following groups of drugs:

beta blockers (Atenolol, Metoprolol, Nebivolol);
ACE inhibitors (Captopril, Enalapril, Fozinopril);
diuretics (Furosemide, Indapamide, Spironolactone);
calcium channel antagonists (Verapomil, Diltiazem, Lacidipine).

Beta blockers neutralize the effects of epinephrine and norepinephrine on special receptors in the heart, resulting in a decrease in heart rate and stabilization of blood pressure. Angiotensin-converting enzyme inhibitors reduce the production of the main mineralocorticosteroid hormone of the adrenal cortex (aldosterone), which prevents an increase in vascular tone.

Hypertensive patients are recommended to take a course of these drugs. The daily dosage is selected individually, taking into account the form of the disease, age and weight of the patient. Thanks to their prolonged action, such tablets allow you to keep your blood pressure under control throughout the day, even with a single dose.

Diuretics utilize excess fluid from the body, preventing the formation of edema, improve kidney function and normalize blood pressure. Calcium antagonists protect the heart muscle from dystrophic changes. For the treatment of nephrogenic hypertension, patients are often prescribed drugs based on Amlodipine. In addition, products of chemical and herbal origin, which are designed to improve the functioning of the organs of the urinary system, provide tangible benefits in the fight against the disease.

Surgical intervention

If a salt-free diet and medication do not bring any results, then it is advisable to think about surgery. Surgical intervention allows you to completely restore vascular patency. Modern clinics are equipped with equipment that allows them to perform high-tech operations with minimal risk to health. The following surgical techniques demonstrate excellent results in the treatment of renal hypertension:

Percutaneous balloon angioplasty. Using a catheter equipped with a balloon, the specialist straightens the stenotic areas of the arteries. The obvious advantage of this manipulation is the fact that the patient is not under general anesthesia during the operation, and the intervention itself takes very little time. In rare cases, complications occur in the form of rupture of a vessel or exacerbation of bleeding.
Open angioplasty. The essence of the operation is to remove atherosclerotic plaques and reconstruct the affected area of the renal artery, for which one’s own vessels or prostheses are used. The advantage of the technique is that the patient’s blood flow is completely restored and deposits that provoke an inflammatory reaction are removed. Old age should be considered a contraindication to surgery, since the likelihood of cardiovascular complications is high.

Treatment of renal hypertension

We have looked at how the kidneys affect blood pressure, now we need to evaluate the treatment offered by medicine and decide what actions should be taken if problems arise. If your blood pressure has increased, you should first visit a cardiologist to identify the exact cause of this phenomenon. If the reading decreases, the need for consultation becomes urgent as immediate medical attention may be required.

It is important to remember that you cannot reduce blood pressure at your own risk; medications must be prescribed by a doctor. In this case, the causes become the “stumbling block” - not knowing what factors caused the disease, the victim can completely destroy the kidneys in attempts to regulate blood pressure levels. Treatment of the disease begins only after a comprehensive examination, and the following methods can be used:

Surgical intervention if cysts, neoplasms and other pathologies form, which cannot be removed by other means.
Drug therapy with the prescription of tablets - this method is in demand if the cause of the pathology is excessive or insufficient production of renin.
With the development of arterial hypertension, treatment should be carried out against the background of diet therapy.
Traditional recipes can be used as an additional and preventive method. Herbal mixtures from which tinctures and decoctions are prepared can demonstrate good results, but it is advisable to first consult with specialists.

As for drugs that are usually prescribed for therapeutic purposes, it is mandatory to take diuretics, which include Furosemide, Hydrochlorothiazide, Amiloride, Triamterene and others. Lisinopril and Enalapril are prescribed, which are ACE inhibitors. Among β-adrenergic receptor blockers, the most popular are Atenolol, Labetalol, and Carvedilol. Vitamin complexes, potassium preparations, calcium antagonists are also prescribed - the latter include Nifedipine and Verapamil.

The drugs serve to normalize blood pressure, and after achieving the goal, they begin to eliminate the underlying pathology. If there are problems with the renal vessels, arterial bypass or balloon dilatation is performed.

If there are no signs of organ functioning, the phenomenon is regarded as a direct need for removal and nephrectomy is performed. In cases where there is chronic renal failure, hemodialysis is prescribed.

Even if measures to normalize the condition were carried out successfully, sudden changes in pressure should not be allowed in the future. The most effective is complex treatment, when drugs are taken against the background of a diet, accompanied by a correct diet and lifestyle, and the drinking regime is not ignored.