FRIDAY, March 21, 2003 (HealthDayNews) -- High blood pressure and diabetes are life-threatening conditions that are nearing epidemic proportions in the United States.
If you've been diagnosed with either one, chances are your doctor has impressed upon you the importance of proper diet, exercise and medications, or some combination of the three. Doing so can ward off heart disease, linked to both diabetes and blood pressure problems.
But there's another vital reason to carefully manage blood pressure problems and diabetes, although many patients are unaware of it: To preserve your kidney health.
"Most people with high blood pressure and diabetes seem to focus on the consequences to their heart," says Dr. Brian J.G. Pereira, president of the National Kidney Foundation.
"But high blood pressure and diabetes are two of the most important causes of kidney disease," Pereira adds.
Diabetes, in fact, is the leading cause of chronic kidney failure, accounting for 35 percent of all cases in the United States, according to the National Kidney Foundation. And high blood pressure, when uncontrolled or poorly controlled, is the second leading cause of chronic kidney failure, responsible for 23 percent of all U.S. cases, the foundation estimates.
"If you can control the blood pressure and diabetes, people survive longer and have slower progression of the kidney disease," says Dr. David Hartenbower, an associate professor at the David Geffen School of Medicine at the University of California at Los Angeles.
The kidneys -- two bean-shaped, fist-sized organs sitting near the middle of the back, just below the rib cage -- can be affected by a variety of other problems that keep them from removing wastes and extra water from the blood to form urine. Among them: kidney infections, stones, cancer, a missing kidney or polycystic kidney disease -- a genetic disorder in which multiple cysts grow in the organ.
More than 20 million Americans have chronic kidney disease, according to the National Kidney Foundation, and another 20 million are at risk for it.
Whatever the cause of the problem, when kidney damage becomes severe, dialysis or a transplant is needed. Every year in the United States, about 80,000 people are diagnosed with kidney failure, according to the National Institutes of Health.
But controlling high blood pressure and managing diabetes could reduce the risk of kidney failure substantially, physicians say.
"In high blood pressure, the vessels get thicker, including those in the kidney, and then they don't work as well," says Hartenbower. Diabetics can have unused glucose in the blood, and this can cause damage to the nephrons, the functioning unit of the kidney.
But the picture's far from bleak, Hartenbower and Pereira say, thanks to a trend toward earlier care of patients by kidney specialists, better drugs, and an awareness that lifestyle changes, such as improving the diet and getting more exercise, can help.
"The big push currently is for primary care physicians, when they recognize someone is developing mild kidney problems, to get them into the hands of a nephrologist [kidney specialist] sooner than they used to," says Hartenbower.
Adds Pereira: "In the last 10 years, the big advances are our understanding of how kidney disease progresses and the advent of new therapies such as ACE inhibitors," drugs given to those with high blood pressure and kidney disease.
"The second advance is our improved understanding of genetic or inherited kidney problems," Pereira adds. "And the third is development of new treatments for complications" of kidney disease.
For instance, if a person with kidney problems has become anemic, a man-made form of the hormone EPO (erythropoietin), normally made by the kidney to trigger the bone marrow to make red blood cells, can be given, Hartenbower says.
The dangerous thing about kidney disease is that it often doesn't produce any signs or symptoms, says Pereira.
"The good news is, you can detect it early and treat it and you can slow its progression," he says. "All you need are three simple tests: a measurement of your blood pressure, a urine test for protein [excess indicates a problem], and a blood test for creatinine. If creatinine is elevated, it means your kidneys are not working properly."
During March, National Kidney Month, the National Kidney Foundation urges all Americans, especially those at risk, to get tested for kidney disease.
More information
For information on kidney disease and diabetes, see the National Institute of Diabetes and Digestive and Kidney Diseases.
The National Institute of Diabetes and Digestive and Kidney Diseases has more information on high blood pressure and kidney disease.
