Health

Kidney failure and renal hypertension

High blood pressure causes stress on the blood vessels of the kidneys, which also contain blood-cleansing units, When this condition lasts for a long time, due to the thickening of the blood vessels present in the inner parts of the kidney, due to the formation of rashes on the blood-filtering units, excess hormones are produced due to reduced kidney function, Due to which water and salt starts accumulating in the body and the person becomes a victim of renal hypertension, the end result of which is kidney failure.

In medical science, the term renal is used for kidney (kidney), renal hypertension means increased blood pressure due to interruption of blood supply to the kidney, it is also called renal artery stenosis. In this chronic disease, renal hypertension is the result of a hormonal reaction caused by obstruction of blood flow due to narrowing of the arteries that carry blood to the kidneys. If not treated early, kidney failure can occur, in severe cases complications such as heart attack, aneurysm and stroke can occur. This is the main reason for 70 percent of kidney failure cases in our country.

According to medical science, blood pumped from the heart exerts pressure on the arteries to flow in the body through the arteries, this pressure or resistance created by the advance of blood in the arteries is called blood pressure. The blood pressure of a healthy person is 120/80 millimeters of mercury (MSHg). There are two numbers in blood pressure, systolic and diastolic. Systolic is the top number, like 120 in 120/80. It is an indicator of the pressure or resistance created by the advance of blood in the arteries after the heart beats. Diastolic is the bottom number like 80 in 120/80. This is a reading of the pressure built up in the arteries between heartbeats.

How does kidney damage?

High blood pressure causes stress on the blood vessels of the kidney, which also contain blood-cleaning units, when this condition lasts for a long time, due to the thickening of the blood vessels present in the inner parts of the kidney, due to the formation of rashes on the blood-filtering units. Due to the reduced working capacity, excess hormones are produced, due to which water and salt accumulate in the body and the person becomes a victim of renal hypertension, the end result of which is kidney failure.

Who is more at risk?

Although this disease can happen to people of any age, but it is more likely in people over 65 years of age, if seen according to the breed, its risk is highest in Caucasian people.

Why does this disease happen?

The kidney cleans the blood, when the veins carrying oxygen and nutrient rich blood from the heart to the kidney start getting blocked, then the person becomes a victim of kidney hypertension. In this condition, the arteries become narrow due to insufficient supply of nutrients and oxygen rich blood to the kidney, it is also called renal artery stenosis.

Another condition called renal artery stenosis is the hardening of the arteries in atherosclerosis. The reason for hardening of the kidney arteries is the accumulation of plaque in the arteries made of substances like fat, cholesterol, calcium. These plaques block blood flow to the arteries of the heart, brain, pelvis, arms, legs or kidneys, leading to complications such as heart attack, stroke, and kidney failure.

Another cause of kidney artery stenosis is fibromuscular dysplasia (FMD), the reason why this occurs is still unknown, but it is not caused by plaque buildup and women are more vulnerable than men. Arteritis, radiation fibrosis and artery block from the graft are other causes of kidney hypertension.

What symptoms emerge?

Its main symptoms are- high blood pressure at an early age, sudden increase in stable blood pressure, decreased kidney function, narrowing of the arteries (especially of the brain, eyes and legs), water filling in the lungs (pulmonary edema) etc.

How is it confirmed?

To confirm this, the doctor, along with knowing the medical history, does blood pressure and physical examination to see if there is any water accumulation in the chest or legs. When disease is suspected, blood tests like kidney function and CBC are done, the results of these tests confirm the disease.

Kidney artery stenosis is more likely if the patient already has arterial disease, the doctor examines the neck and abdomen with a stethoscope, which helps in the identification of narrowed arteries, a hoarse sound is heard in the stethoscope when blood flows in the narrowed artery which is called brute. If narrowing of the artery is suspected, the doctor may conduct imaging tests such as duplex ultrasound, CT images, MRA and catheter angiogram. Remember that narrowing of the kidney artery does not mean that the patient has high blood pressure because of this, because in many people the blood pressure remains fine even after narrowing the arteries, in such a situation only the doctor can tell the root cause of kidney hypertension.

What is its treatment?

First of all, blood pressure is controlled in its treatment, for this many medicines are available. The doctor decides which medicine will be effective. More than one drug is involved in the treatment and it is also changed if it is not effective as per the need.

There are usually two types of drugs – angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). In most cases, only one of these types of medicine is given. In kidney artery stenosis, where both arteries are narrowed, these drugs reduce kidney function, so kidney function tests are needed weekly to know their effect and it takes several weeks for the drug to set. To remove the excess water accumulated in the body, diuretic drugs are given along with these medicines.

Stenting/Angioplasty: Stenting or angioplasty is done when there is a severe narrowing of the kidney artery, this improves blood flow to the kidney, helps prevent kidney failure and controls blood pressure with minimal medications. In angioplasty, the doctor inserts a catheter through an artery in the arm or leg and moves a small, inflated balloon into the blocked area to reduce the narrowing of the artery. In this procedure, the balloon is inflated and deflated (angioplasty) several times to flatten the artery walls. After the procedure, the balloon and catheter are removed from the body. In many cases, stenting is needed along with angioplasty, in which a small mesh tube called a stent is inserted through the catheter into the narrowed space of the artery so that it does not shrink again. In this procedure, the stent is left in place permanently.

By-pass surgery: Kidney bypass surgery is performed if medication or angioplasty does not improve the condition and the narrowing recurs or if a stent cannot be placed in the artery for some reason. In this, by taking a vein or a synthetic tube to connect the kidney to the aorta (the aorta), the surgeon creates an alternate route, or bypass, so that the blood can flow properly into the blocked artery of the kidney. This procedure is complex and high risk, so it is used only in rare cases.

Note: Remember that angioplasty-stenting will not necessarily cure high blood pressure, medications are still needed after these procedures to control blood pressure. Yes, it is possible that the dosage of the drug is reduced as well as the risk of kidney failure decreases.

Complications

Kidney hypertension can lead to complications such as renal failure, myocardial infarction, stroke, pulmonary edema, retinopathy, left ventricular hypertrophy, congestive heart failure, aneurysm and vascular dementia. If kidney hypertension is not treated, its end result comes out in the form of kidney failure. The average age at its final stage is a maximum of two years.

life with kidney hypertension

If the disease is confirmed, take medicines on time so that blood pressure is controlled. Doctors usually recommend procedures such as angioplasty-stenting to those patients whose blood pressure is not controlled by medicines or who have serious side effects of medicines such as rapid filling of the lungs i.e. flash pulmonary edema. There is no home remedy for kidney hypertension, nor do it come under the guise of any quack. Eat healthy food and take medicines on time as directed by the doctor. Adopt a healthy lifestyle, include vegetables, grains and low-fat dairy foods in the diet. Exercise regularly and walk for at least 30 minutes a day. Lose weight if you are obese, stop smoking and drinking caffeine. Limit sodium (salt) in the diet, avoid stress.

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