The kidneys are one of the most vital parts of the body. They remove a major part of toxic and waste material from the body. Their good functioning is very important to maintain good health. There are a number of factors that can damage the kidneys and impair their functioning. Hypertension is one of the most common conditions that can damage the kidneys and result in kidney failure. In hypertension, blood flows with greater pressure through the blood vessels. Overtime the blood vessels of the kidneys, as well as that of other body parts, start getting damaged due to high blood pressure. This deranges the kidney function. Impaired functioning of the kidneys also raises the blood pressure. Thus, a vicious cycle is created which further impairs the kidney function. Ultimately kidney failure sets in. Diseases of the kidneys also cause hypertension, which is technically known as secondary hypertension. This is the main cause for hypertension in children and young adults. Congenital abnormalities of the kidney, infections, and tumours of kidney are such conditions. Renal failure due to hypertension is a major cause of sickness and death in developed countries. Due to increased life span of people and better medical facilities, a greater number of people in underdeveloped countries are also being detected as having renal failure due to hypertension. Thus, it can be seen that hypertension and kidney problems are closely linked to one another. Kidney damage is further aggravated if diabetes is present in addition to hypertension. Early renal failure usually passes unnoticed and may be detected only while doing routine laboratory tests. As the disease progresses, the quantity of urine passed reduces. This is also not noticed usually, till it becomes severe. In later stages, one develops swelling over the face and then over the whole body, anaemia, vomiting, weakness and reduction in the quantity of urine passed. Chronic renal failure is diagnosed by specific laboratory tests like measuring blood urea, creatinine levels, urinary proteins, glomerular filtration rates, etc. Once the kidneys are damaged, it becomes a point of no return. The drugs which are prescribed are only for controlling the vomiting, weakness, hypertension, and other manifestations of renal function. Dialysis is used to remove the toxins from the body but it has lot of adverse effects and is painful. Ultimate treatment lies in renal transplant, i.e. replacing the diseased kidney with a healthy one. This is a cumbersome and expensive procedure. Moreover, one has to find a kidney which matches very well with the tissue typing of the person needing it. Mostly it is a blood relative who is suitable for donation of a kidney. Even after that, there is risk of rejection of the grafted kidney. To prevent that, long term immune suppressive drugs are used which further weaken a person. Therefore, it is important to keep the blood pressure under good control to avoid kidney damage. This is possible through lifestyle measures like reduction of body weight, low fat and salt restricted diet, regular physical exercise and mental, physical relaxation. Avoidance of alcohol and tobacco use is very beneficial in preventing hypertension. Good compliance with drugs for hypertension and diabetes is mandatory to keep these conditions under control. Those suffering from hypertension should get tests for kidney function done once every year. Thus, any damage to the kidneys can be detected at the earliest and prevented from progressing. Those suffering from kidney diseases also need to be adherent to medicines and prescribed drugs. This will ensure that hypertension remains controlled and further kidney damage is spared. A person can have a good quality of life, in spite of having hypertension if he keeps the blood pressure controlled and avoids kidney damage. Dr Rachna Pande is a specialist in internal medicine.
