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How Hypertension Is Linked To Diabetes And Kidney Failure?
By Ng Peng Hock
Are you aware that about 40 percent of Asian diabetic patients with hypertension eventually develop kidney disease, 10 percent of these patients will require dialysis within 10 years of diagnosis? And, only 25 percent of these dialysis patients will survive for 5 or more years from the time of initial diagnosis of their kidney ailment.
Both high blood sugar levels and hypertension increase the risk of kidney failure for diabetics. Presence of protein in urine is the earliest sign of kidney disease.
On the other hand, hypertension is also a risk factor for non-diabetic kidney disease and contributes to kidney failure. Apparently, increases the pressure within the kidney filter, leading to its damage and to the leakage of protein in the urine. A substance presented in the blood stream and in the tissues, known as angiotensin II, contributes to hypertension-related damage and scarring in the kidney.
Hence, blocking the effects of angiotensin II by drugs is an important part of the treatment of hypertension and kidney disease. Basically, there are 3 approaches to the treatment of hypertension and diabetic kidney disease:
1. controlling the patient’s blood sugar to bring it to normal levels,
2. reducing blood pressure to optimal levels,
3. blocking the effects of angiotensin II.
These approaches are most effective when used together. Intensive treatment to achieve normal blood sugar levels through oral drugs insulin, a strict low-carbohydrate diet, avoidance or cession of smoking, regular exercise and maintenance of a healthy body weight can reduce the risk of diabetic kidney disease.
It
has been shown that control of hypertension can slow down the progress of kidney disease. Maximum benefit can be achieved when the patient’s blood pressure is below 130/80 mmHg. This target blood pressure level can be maintained usually with more than one type of blood pressure lowering drug. Two classes of drug, Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II receptor blocker (ARB), have been shown to prevent or slow down kidney failure independent of their effects on blood pressure. When used early in the treatment of hypertension, these two drugs show their effectiveness in eliminating protein in the urine and preventing the onset of diabetic kidney disease.
It is mandatory for all diabetic patients to have urine testing for protein in order to detect the onset of kidney disease in its early stages. Furthermore, the lowering of blood cholesterol to normal levels, avoidance or cession of smoking, aspirin therapy and regular exercise are likely to prevent death from heart attack or stroke among these patients.
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