Kidney Disorders And High Blood Pressure
Kidney Disorders and High Blood Pressure
You only need 10 percent of one kidney working correctly to experience no symptoms of
kidney failure.1 This is what makes end-stage renal disease (ESRD) such a menacing problem, and more than
661,000 people in the US are afflicted with ESRD.2 High blood pressure (hypertension) and diabetes are the
underlying causes in nearly two-thirds of all kidney disease cases (per the National Kidney Foundation).3
Did you know that kidney disease can actually cause hypertension (termed secondary
hypertension)? Therefore, maintaining control over blood pressure (BP) is vital to preserving your kidney
function. Indeed, the CDC notes that diabetics diagnosed with kidney disease (diabetic nephropathy) may be
prescribed BP-lowering drugs to prevent worsening of that nephropathy.4
Other Causes of Chronic Kidney Disease
WThe following are four other causes of chronic kidney disease (CKD) that can eventually
lead to ESRD:
- Glomerulonephritis (third-leading cause of CKD and accounts for 10 percent of all patients on
- Interstitial nephritis – often precipitated by an allergic reaction or overuse of “over-the-counter”
- Systemic Lupus Erythematosis (SLE) – an autoimmune disorder that can damage the kidneys and other
- Polycystic kidney disease (hereditary disorder involving growth of noncancerous cysts in kidneys).
Glomerular Filtration Rate (GFR) – Why It Matters
Nephrologists (kidney specialists) understand that the GFR test result shows the ability
of your kidneys to remove waste from the blood. Your GFR is determined by a lab-based test of your blood
creatinine in combination with the following factors: 1) your current age; 2) gender; 3) height; and 4)
A low GFR number is specifically linked to kidney dysfunction, but albumin or protein in
your urine can also be interpreted as a warning sign of kidney disease. Meanwhile, ESRD symptoms often
include leg cramps, fatigue, itchy skin, and swelling of arms or legs (as well as nausea and mental
Five Stages of Kidney Disease
Kidney disease stages are classified by both the kidney damage level and the glomerular
filtration rate (GFR). These five stages—that nephrologists use in formulating a treatment plan— are:6
- Stage 2 – Kidney damage with mild decrease in GFR (with 60 – 89 GFR).
- Stage 3 – Moderate decrease in GFR (30 – 59 GFR).
- Stage 4 – Severe reduction in GFR (15 – 29 GFR).
- Stage 5 – Kidney failure (less than 15 GFR) – signifying need for dialysis.
Avoiding Dialysis – Is it Possible?
Consuming a low-protein diet is typical in the dietary management of CKD. An article in
the New England Journal of Medicine also recommends ingesting carbohydrates with a high fiber content
(e.g., whole-grain breads), as opposed to carbohydrates without much fiber content.7
Moreover, the conclusion of a research article in April, 2018 in Nutrients was that daily
protein intake in people living with CKD should be reduced to 0.8 - 1.0 grams per Kg of body weight.8 By
eating a high fiber diet, overweight adults with CKD can also reduce their Body Mass Index (BMI) to within
a normal range—thereby reducing stress on the kidneys.
Since a high sodium intake reduces the ability of the kidneys to remove excess water in
the blood—which can cause hypertension—consuming fewer salty foods is advisable if you have either high BP
or kidney disease. Even for people who do not have kidney disease, a maximum of one teaspoon per day is
most often recommended.9
Some foods especially high in sodium chloride (salt) are:
- Smoked or canned meat and fish;
- Frozen pre-packaged dinners;
- Potato chips and salted nuts;
- Most canned soups
For people with kidney disease that is not yet considered end-stage, careful dietary
management can stave off dialysis for a few years or more. An alternative to dialysis is a kidney
transplant, but waiting lists can be long if no living donor—who is also a good tissue match—can be
identified for you.
Your primary care physician is likely to refer you to a nephrologist if you are diagnosed
with kidney disease. In turn, a nephrologist may prescribe a diuretic to aid in the elimination of excess
Mayo Clinic. Diseases and Conditions – End-State Renal Disease. Webpage:
National Institute of Diabetes and Digestive and Kidney Diseases. Kidney Disease Statistics
for the United States. Webpage:
National Kidney Foundation. Kidney Disease: The Basics. Webpage:
Salifu MO, et al. (Updated February 1, 2017). Nephrology – Chronic Glomerulonephritis.
National Kidney Foundation. Nutrition and Chronic Kidney Disease (Stages 1-4): Are You
Getting What You Need? Webpage:
Kalantar-Zadeh K, and Fouque D. (2017). Nutritional Management of Chronic Kidney
Disease. New England Journal of Medicine 377: 1765-1776. Webpage:
EveryDayHealth.com. 10 High-Sodium Foods to Avoid. Website:
Salifu MO, et al. (Updated February 1, 2017). Nephrology – Chronic