The High Pressure of Kidney Disease

Kidney disease linked to high blood pressure that does not respond to routine therapy

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Sometimes blood pressure can be controlled by lifestyle changes alone. But in other cases, several types of medications may be needed to do the trick.

High blood pressure that doesn’t respond to treatment with two or even three types of medications may be common in patients who have kidney disease, says a new study.

According to the authors of this study, these findings could help identify patients with kidney disease and ensure they get the extra care needed to control their high blood pressure.  

"Get your blood pressure checked regularly."

This study was conducted by Rikki Tanner, MPH, and Paul Muntner, PhD, at the University of Alabama at Birmingham School of Public Health, along with colleagues.

The aim of this study was to explore the link between chronic kidney disease and resistant hypertension (high blood pressure).

Resistant hypertension is a condition where four or more medications are needed to control the patient’s high blood pressure.

In chronic kidney disease, the kidneys malfunction over a long period of time. Kidney damage can lead to several complications, including high blood pressure.

For this study, the researchers looked at data from 10,700 people with hypertension who participated in a large study called the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study.

After looking at this data, the researchers found that more than 50 percent of participants who had chronic kidney disease also had resistant hypertension.

There was a strong association between poor kidney function and the presence of resistant hypertension. The worse the kidney function, the higher the severity of resistant hypertension.

Among people with chronic kidney disease, resistant hypertension was more common in African Americans and participants with a larger waist circumference, diabetes or a history of heart attacks or strokes than in those without those factors.

"These data indicate that resistant hypertension is a common condition among individuals with kidney disease," Tanner said in a press statement.

"The identification of individuals at high risk of developing resistant hypertension who may benefit from intensive blood pressure monitoring and early therapeutic interventions — such as treatment for secondary hypertension, referral to a hypertension specialist, and cessation of medications that increase blood pressure — should be a high priority," Tanner said.

The authors noted some limitations to the study. It was not possible to tell if the high blood pressure was a result of kidney disease or the kidney disease developed because of high blood pressure. Also, since dosing information was not available for the medications, the researchers could not tell if an individual was indeed not responsive to treatment or wasn’t taking the right dose of medication.

The authors suggested further studies be conducted to determine if chronic kidney disease patients will benefit from home blood pressure monitoring.

The results of this study were published June 18 in the Clinical Journal of the American Society of Nephrology.

The study received funding from the National Institute of Neurological Disorders and Stroke, the National Institutes of Health, the Department of Health and Human Services and Amgen Corporation, a pharmaceutical company.

Review Date: 
July 18, 2013
Last Updated:
July 31, 2013