Chronic kidney disease (CKD) is a condition that develops when the organs in your body responsible for filtering the blood are damaged, meaning that the waste debris from cells, and toxins from things like alcohol that we consume can’t be excreted properly by the body.
It is often only diagnosed when something else goes wrong because it doesn’t present with many symptoms. The main diagnostic tool is a simple blood test. Creatinine, which is a waste product of the blood, is measured and then considered alongside your age, size and gender to see how fast your kidneys are filtering the blood. If they are filtering less than 90 ml/min (known as eGFR) then you have CKD.
One of the most common causes for chronic kidney disease is hypertension, or high blood pressure. The arteries that carry the blood to the kidneys narrow, putting more pressure on the blood flowing through them. This leads to damage to the arteries as well as the surrounding kidney cells, impairing their ability to carry out their function and leading to the body being unable to filter blood.
Having severely high blood pressure can cause your kidneys to deteriorate relatively quickly, with milder forms of hypertension still able to cause damage over several years. As a result, it’s extremely important to take steps to control your hypertension in order to slow the progression of your CKD.
How to Manage Hypertension
Regular Monitoring
There are several different methods available for controlling the blood pressure of the body. First and foremost, it’s important to think about getting a home blood pressure testing device, so that you can keep track of your blood pressure on a regular basis and catch any early warning signs that your blood pressure may be spiking. Since hypertension also has few symptoms, regular monitoring can help keep you on top of your health.
However, it is also important to note that the blood pressure of the body will change throughout the day and as a result of any changes to your daily routine, like not getting enough sleep, or after exercise. So, make sure to keep a regular routine around when you test yourself with your device, and keep track of your blood pressure over time to bring with you to your doctor’s appointments.
Daily Medications
For more direct management of your blood pressure on a day-to-day basis, being sure to take your medications every day as prescribed is important. Some of the medications you may be prescribed include:
- ACE inhibitors – angiotensin-converting enzyme
- ARB – angiotensin receptor blockers
Both of these medications work on angiotensin. Angiotensin is an important enzyme within the body that helps to control the amount of water that is stored as well as the amount that is excreted into urine by the kidneys. It does this through a variety of different methods, including balancing the amount of salt present, and through a few physicochemical interactions with other enzymes around the kidneys. Ultimately, angiotensin is responsible for the narrowing of the arteries, and contributes to hypertension.
The two medications above reduce the functionality of angiotensin. ACE inhibitors reduce the amount of available angiotensin, while ARBs decrease the effects of the remaining angiotensin. Together, these medications help stop the effect of angiotensin and reduce the narrowing of the arteries to lessen blood pressure.
Dietary Modifications
Several alterations to the diet can also help to mediate the effect of hypertension on the progression of CKD. These include changing the food you eat, monitoring your daily caloric intake, and avoiding toxins such as alcohol and other recreational drugs.
Modifying your diet to be a low-sodium diet can be beneficial for your hypertension as it helps to manage the amount of water your kidneys retain. The balance of salt and water can manage the fluid volume of the arteries and cells around the kidneys. Maintaining a low-salt diet helps to reduce the amount of water that stays in these cells, reducing the volume within the arteries and in turn lowering blood pressure.
Another useful item in the toolkit here is a low-protein diet, which can decrease the overall amount of sodium you consume. This helps to reduce hypertension as well as protein waste in the kidneys, which in turn avoids increasing load on the kidneys for CKD patients.
Monitoring your daily caloric intake can be an important part of looking after your overall health, and is especially important in reducing hypertension and slowing the progression of your chronic kidney disease. This is because diabetes is a significant risk factor for kidney disease, and obesity is associated strongly with the development of diabetes. Maintaining a healthy caloric intake helps to avoid developing additional comorbidities associated with hypertension and CKD that may complicate or hinder your health further.
Another essential part of managing your diet for hypertension is to avoid consuming alcohol. Alcohol has a role in inducing hypertension, but research is still being done on elucidating exactly how this occurs within the body. Some think that it could increase stress within the body, or that it could change the width of the arteries to alter blood pressure. Regardless, alcohol can also cause damage to the kidneys, as well as exacerbate hypertension, so those with CKD should steer clear.
Figure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038773/figure/F1/
General Tips & Tricks
Hypertension can also be exacerbated by some lifestyle choices. For example, quitting smoking is a great way to reduce hypertension. Some other lifestyle changes are:
- Getting enough sleep: Make sure you are getting around 7-9 hours of sleep per day.
- Being physically active: Being active changes your blood pressure in both the short and long term, so maintaining an active lifestyle can be a great way to lower your blood pressure over time.
- Engage in self care: Looking after yourself can help to lower your stress levels and keep your blood pressure in check.
