High Blood Pressure and Kidney Disease

In this posting, Dr Stephen Chew Tec Huan, a Consultant Nephrologist and Physician will take a look at high blood pressure in relation to kidney disease.

High blood pressure in the setting of kidney disease is usually more difficult to control. Patients may need on the average 3 to 4 medications to reach blood pressure targets. There are several reasons why BP control may be difficult.

1: Patients omit their medication - If omitted they will have blood pressure problems uncorrected. Some patients take their medication only after they realize that a doctors visit is coming up. However, even if their pressures become normal, they would eventually suffer from problems of period of unsustained and only intermittent blood pressure control.

2. Patients continue with a high salt diet - Restricting salt is an important measure in controlling bp. Even without adding extra salt or sauce to our meals, the asian diet tends to be high in salt. Canned foods are another potential source of salt that the patient may be taking without realizing it.

3. Other medications like erythropoeitin may aggravate hypertension - You will need to discuss with your doctor on the relative importance of the issues at hand; ie is taking the injection critical versus the need or ability to control the blood pressure. Sometimes simple medication like flu medication can aggravate hypertension.

4. Certain antihypertensive medication can paradoxically cause periodic increases in hypertension. Your doctor is the best person to discuss this with.

Keywords: blood pressure, hypertension, kidney failure, diabetes, salt