High Blood Pressure in Kidney Failure: Causes & Treatments

At least six in 10 adults and up to one third of children with ADPKD have high blood pressure (also called hypertension). It may be the first sign of ADPKD, and may be diagnosed when kidney function is normal.

It is unclear why people with ADPKD have high blood pressure, but early and effective treatment is essential. Controlling blood pressure to the recommended target or level may slow the progression of kidney disease and lower the risk of aneurysms and stroke or heart attack. Some people can lower their blood pressure by changing their lifestyle, but you may also need medication to lower your blood pressure to the recommended level.

You have high blood pressure (or hypertension) if your blood pressure is consistently 140/90 mmHg or higher when it is measured by your doctor. High blood pressure is a problem for anyone because it means that your heart has to work harder to pump blood around the body, increasing your risk of heart attacks and strokes. But high blood pressure is a particular concern for people with ADPKD:
It puts extra strain on your kidneys and may speed up the progression of kidney damage.

It may also increase the likelihood that aneurysms or bulges in the walls of the blood vessels of the brain will burst.

If lifestyle changes do not control your blood pressure, your doctor will suggest that you also take medication. You should continue with your healthy lifestyle, as it will help control your blood pressure and improve your general health. You may need more than one drug to keep to your target blood pressure, but the following are often used:

ACE inhibitors or angiotensin-II receptor blockers (ARB) work by reducing the production of hormones that cause your blood vessels to become narrower. These drugs slow loss of kidney function in people with other types of kidney disease. Studies are currently under way to see if these drugs also slow disease progression in people with ADPKD.

Calcium-channel blockers to relax the blood vessel walls and widen the blood vessels.

Diuretics (water tablets) lower the blood pressure by helping your kidneys to remove more water and salt from your blood.

Once your blood pressure is at a healthy level, you will need to continue with your healthy lifestyle and your prescribed medication. If you have side effects, never stop taking your tablets without first talking to your doctor. There are many types of blood pressure-lowering medication, and you can work with your doctor to find the combination that is right for you. Monitoring your blood pressure You should have your blood pressure checked regularly by your doctor. You might also consider buying your own blood pressure monitor so that you can also keep an eye on your blood pressure at home.

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