How High Blood Pressure Can Lead To Kidney Damage

The kidneys are very delicate organs with intricate circuits that filter blood to produce urine. The blood will first be drained through the blood vessel "afferent arteriole" to our filtering structure "glomerulus", and the filtrate will then pass through the "renal tubules" to recover nutrients and eliminate waste, and finally form urine. As the most important excretory organ in our body, once the kidneys lose their function, the toxins and excess water produced by the metabolism in the body cannot be effectively eliminated.

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Chronic kidney disease refers to irreversible abnormalities in function or structure of the kidneys after long-term damage (lasting more than 3 months). There are many reasons for the impairment of renal function in chronic kidney disease, such as: high blood pressure, diabetes and other metabolic-related diseases, other inflammations such as immunity and infection, or injury from drugs and toxic substances.

If chronic kidney disease continues to worsen, it will eventually develop into end-stage renal disease, which will lead to the accumulation of a large amount of urinary toxins. In addition to significantly increasing the risk of cardiovascular disease, end-stage renal disease will also greatly affect the quality of life due to the need to rely on renal replacement therapy (dialysis/peritoneal dialysis). This article will introduce several common causes of chronic kidney disease, and explain the current medical process and stages of chronic kidney disease.

The relationship between 'three highs' and kidney disease

The three highs (hypertension/hyperglycemia/hyperlipidemia) are inseparable from the progression of chronic kidney disease. If the kidney is roughly compared to a filter, the damage to kidney function may be reflected in the total amount of filtration, that is, the blood flow filtered by the kidney - "glomerular filtration rate (eGFR)". If the glomerular filtration rate is too low, it means that the blood flow filtered by the kidneys is reduced, which means that the kidneys cannot perform their function of filtering blood well. In addition, the decline in renal function can also be reflected in whether the filter is damaged - the production of "proteinuria". Long-term poorly controlled high blood sugar, high blood pressure, and high blood lipids will reduce the flow of kidney filtration, and even cause the structure of the filter to be damaged, resulting in gradual damage to the kidneys. Let me tell you one by one below.

Cistance

The first is high blood pressure. Long-term poor control of blood pressure will lead to excessive pressure in the glomerulus. In order to resist excessive resistance, blood vessels will be narrowed compensatoryly, and the structure will become brittle and hard at the same time. Gradually, the blood vessels will narrow due to the narrowing of the diameter of the blood vessels, which will lead to a decrease in blood flow in the kidneys, and the amount of filtration will also decrease. Eventually, the renal filtration function will be damaged in the form of a decrease in the glomerular filtration rate and an increase in the loss of protein in the urine, resulting in high blood pressure. Blood pressure nephropathy.

In addition to damaging the glomerulus and endothelial cells by soaking cells in a high-sugar environment for a long time, high blood sugar can also indirectly cause renal hypertension, leading to excessive use of glomerular filtration function (hyperfiltration), and the kidneys gradually develop into diabetic nephropathy.

Finally, hyperlipidemia may lead to the accumulation of fatty plaques on the blood vessel walls, causing narrowing and hardening of the perfusion arteries.

The three highs not only interact with each other but are inseparable from "metabolic syndrome". Metabolic Syndrome (Metabolic Syndrome) is a preventable and treatable disease. If it is not detected and treated early, it will increase the risk of diabetes by 6 times, the risk of high blood pressure by 4 times, the risk of hyperlipidemia by 3 times, and the risk of heart disease and brain disease by 2 times. Stroke risk, becoming a chronic disease patient. Metabolic syndrome can be said to be the predecessor of the three highs. If three or more of the following five points are met, it can be judged as metabolic syndrome:

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Abdominal obesity: waist circumference ≧ 90cm for men, waist circumference ≧ 80cm for women

High blood pressure: systolic blood pressure ≧ 130mmHg or diastolic blood pressure ≧ 85mmHg

High fasting blood sugar: fasting blood sugar ≧ 100mg/dL

High fasting triglycerides: ≧ 150mg/dL

Low HDL cholesterol: Men < 40mg/dL, Women < 50mg/dL

As mentioned above, metabolic syndrome and three highs may affect our kidney function, causing our kidneys to slowly damage and cause chronic kidney disease. Chronic kidney disease in the early stage does not show symptoms, so it often causes patients to delay diagnosis and delay the opportunity for early treatment to stop the deterioration. Therefore, regular screening should be carried out for high-risk groups of kidney disease. We can classify chronic kidney disease into stages through the degree of glomerular filtration rate and proteinuria. Serum creatinine (Creatinine) is the most common test method for renal function, but it is less sensitive to early chronic kidney disease. Therefore, current health education recommends converting it to glomerular filtration (eGFR) as the basis for chronic kidney disease staging. According to the 2002 KDOQI guidelines, the progression of chronic kidney disease can be divided into five stages according to the estimated glomerular filtration rate (eGFR):

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