An article explains the hidden connection between hypertension, diabetes and kidney disease

Hypertension and kidney disease

- Damage to the kidneys caused by hypertension: Long-term hypertension can cause hardening of the arterioles in the kidneys, leading to increased renal vascular resistance and reduced renal blood flow. Increased pressure in the glomeruli can cause fibrosis and hyaline changes in the glomeruli, which in turn affects the filtration function of the glomeruli. As the disease progresses, the renal tubules will also atrophy due to ischemia, eventually leading to renal failure. Clinical studies have shown that the longer the course of hypertension and the worse the blood pressure control, the higher the risk of kidney damage. Hypertensive nephropathy is often manifested in the early stages as increased nocturia, followed by proteinuria, and in severe cases, hematuria, renal dysfunction and other symptoms.

- The impact of kidney disease on hypertension: The kidney is an important organ for regulating blood pressure. When the kidney is diseased, it will cause the activation of the renin-angiotensin-aldosterone system (RAAS), leading to water and sodium retention and vasoconstriction, thereby increasing blood pressure. This type of hypertension caused by kidney disease is called renal hypertension, which accounts for about 5% - 10% of all hypertension cases. Once renal hypertension occurs, it is often difficult to control, further aggravating kidney damage and forming a vicious cycle.

Diabetes and kidney disease

- Damage to the kidneys caused by diabetes: Diabetic nephropathy is one of the most common microvascular complications of diabetes. Long-term high blood sugar can cause microvascular lesions in the kidneys, thickening the glomerular basement membrane, dilation of the mesangial area, and increase in glomerular filtration rate. As the disease progresses, the glomeruli gradually harden, the tubules atrophy, proteinuria appears, and renal function gradually declines. The occurrence of diabetic nephropathy is closely related to the course of diabetes and the level of blood sugar control. The longer the course of the disease and the worse the blood sugar control, the greater the possibility of kidney involvement. In addition, diabetic patients are also prone to urinary tract infections, which further aggravate kidney damage.

- The impact of kidney disease on diabetes: When kidney function is impaired, it affects the metabolism and excretion of insulin. Insulin is degraded and cleared in the kidneys. When renal function is impaired, insulin clearance is reduced, which can easily lead to insulin accumulation in the body and increase the risk of hypoglycemia. At the same time, kidney disease can also affect the regulation of sugar metabolism, making blood sugar control more difficult and further aggravating the condition of diabetes.

The combined effects of hypertension, diabetes and kidney disease

Hypertension and diabetes often coexist, and the two work together to cause more serious damage to the kidneys. Hypertension will aggravate the hemodynamic changes in the kidneys of diabetic patients, further increase the pressure in the glomeruli, and accelerate the progression of diabetic nephropathy; and the renal microvascular lesions caused by diabetes will reduce the kidney's ability to regulate hypertension, aggravating the condition of hypertension. This vicious cycle will accelerate the progression of kidney disease, and patients are more likely to develop end-stage renal failure and require dialysis or kidney transplantation.

The relationship between hypertension, diabetes and kidney disease is complex. For patients with hypertension and diabetes, blood pressure and blood sugar should be actively controlled, and kidney function tests should be performed regularly to detect kidney damage early and intervene in time. At the same time, for patients with kidney disease, it is also necessary to pay close attention to changes in blood pressure and blood sugar, take comprehensive treatment measures, delay disease progression, and improve quality of life.