High blood pressure (hypertension) is a leading cause of kidney disease and kidney failure (end-stage renal disease) in Anguilla. If high blood pressure is adequately controlled kidney damage and many other complications can be prevented. Elevated high blood pressure overtime, can put strain on the small blood vessels in the kidneys and stop the kidneys working properly.
Functions of the kidneys
Your kidneys are a pair of regulatory organs located on either side of your back. Their main function is to act as a filter system that removes waste products and excess fluid from the body. Over time, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden. These damaged arteries are not able to deliver enough blood to the kidney tissue. Damaged kidney arteries do not filter blood well. As a result the kidneys lose their ability to filter blood and regulate the fluid, hormones, acids and salts in the body. Uncontrolled high blood pressure can also affect the kidneys in another way; that is, they can prevent the kidneys from regulating your blood pressure. Healthy kidneys produce a hormone called aldosterone to help the body regulate blood pressure. Kidney damage and uncontrolled high blood pressure each contribute to a negative spiral. As more arteries become blocked, and stop functioning, the kidneys eventually fail.
Chronic kidney disease
Chronic kidney disease (CKD) is a long-term condition where the kidneys do not work as well as they should. In Anguilla, uncontrolled blood pressure and diabetes are the most common cause of chronic kidney disease. This condition might take years to develop and in its early stages there are few if any symptoms. It may only be diagnosed if you have a blood or urine test for another reason and the results show a possible problem with your kidneys. At a more advanced stage, symptoms can include:
• tiredness
• swollen ankles, feet or hands
• shortness of breath
• feeling sick
• blood in your urine (pee)
Treatment for chronic kidney disease
At this time there is no cure for chronic kidney disease, but treatment can help relieve the symptoms and stop it getting worse. Treatment will depend on how severe of the condition. The main treatments are:
• lifestyle changes to help you remain as healthy as possible
• medications to control associated problems such as high blood pressure and high cholesterol
• dialysis – treatment to replicate some of the kidney’s functions; this may be necessary in advanced CKD
• kidney transplant – this may also be necessary in advanced CKD
Preventing kidney disease
You are more likely to develop kidney disease if you have uncontrolled high blood pressure, diabetes, heart disease and a family history of kidney failure. Preventative measures are focused on these issues. You can protect your kidneys by preventing or managing health conditions that cause kidney damage, such as diabetes and high blood pressure. The steps described below may help keep your whole body healthy, including your kidney.
You should make healthy food choices. Choose foods that are healthy for your heart and your entire body. If you are not sure about these foods talk to your doctor or dietitian/nutritionist.
You should make physical activity part of your routine. Be active for 30 minutes or more on most days. If you are not active now, ask your doctor about the types and amounts of physical activity that are right for you. Get involved in some activity. It could be cricket, football, netball, swimming, walking, dancing or gardening.
You should aim for a healthy weight. If you are overweight or have obesity, work with your healthcare provider or dietitian to create a realistic weight-loss plan.
Limit alcohol intake – Drinking too much alcohol can increase your blood pressure and add extra calories which can lead to weight gain. If you drink alcohol, limit yourself to one drink per day if you are a woman – and two drinks per day if you are a man. One drink is:
• 12 ounces of beer
• 5 ounces of wine
• 1.5 ounces of liquor
If you are a diabetic you should aim to have tight control over your blood glucose levels.
If you suffer from high blood pressure – Keep your blood pressure numbers close to your goal. The blood pressure goal for most people is below 140/90 mm Hg. If your doctor prescribes medications take them as ordered and do not share medications with relatives and friends. Talk with your healthcare provider about certain blood pressure medicines, called ACE inhibitors and ARBs, which may protect your kidneys.
Many residents of Anguilla do not know their blood pressure readings. It is important to have your blood pressure checked by a health professional at regular periods. Remember you can have high blood pressure and have no symptoms at all.
Conclusion
Chronic kidney failure is very common in Anguilla. Uncontrolled diabetes and uncontrolled hypertension are common underlying factors. Kidney failure, due to high blood pressure, is a cumulative process that can take years to develop. But, you can limit your risk by managing your blood pressure. Do not let high blood pressure damage your kidneys.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
