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Introduction
Chronic kidney disease and hypertension are two serious disorders that are closely connected. This connection has not been fully researched yet. Thus, it has been found that up to 63% of people suffering from chronic kidney disease are hypertensive (López-Novoa, Martínez-Salgado, Rodríguez-Peña & López Hernández, 2010). It is also known that high blood pressure is often poorly controlled in patients who undergo hemodialysis (Kauric-Klein, 2013). Nonetheless, researchers have not identified particular risk factors that lead to development of the hypertension in patients with chronic kidney disease and vice versa. Research on treatment and prevention has numerous gaps.
The Link between the Two Diseases
As has been mentioned above, people with chronic kidney disease are prone to hypertension and vice versa. There are a number of works on the link between the two diseases. For instance, Kauric-Klein (2013) notes that cardiovascular disorders account for about 50% of deaths in patients suffering from chronic kidney disease and hypertension is one of major risks of development of cardiovascular diseases. López-Novoa et al. (2010) state that high blood pressure is the second leading cause of development of end-stage renal disease. High blood pressure leads to nephrosclerotic glomerulopathy, which deteriorates proper renal function. At the same time, patients with chronic kidney disease are likely to develop hypertension. Thus, 40% of patients with the second stage of chronic kidney disease have high blood pressure (López-Novoa et al., 2010). It has also been acknowledged that high blood pressure can cause development of mild renal dysfunction that can lead to development of more serious hypertension, which, in its turn, will deteriorate renal function. Clearly, various risk factors contribute to development of the two disorders.
Risk Factors
Among risk factors, the most significant are age, nutrition, inappropriate treatment, lifestyle as well as gender and race. It is necessary to add that the combination of two or more risk factors increases the chance of development of the two diseases. Although there are some works on the risk factors, there are numerous gaps in the knowledge. Existing literature on the matter focuses on age though some other factors are also identified. Kauric-Klein (2013) states that age is one of the most significant risk factors as the older people get the higher blood pressure they have and the more deteriorated their renal function becomes. Smart et al. (2013) note that more than 13% of Australians aged over 25 have chronic kidney disease (stages 3-5) while 30% of adults aged over 65 have chronic kidney disease (stages 3-5).
Of course, nutrition plays an important role in preventing or treating hypertension and renal disorders. People who do not control consumption of liquids are at a higher risk of developing a more severe chronic kidney disease. Nutrition is essential in prevention and treatment of the disease. Kauric-Klein (2013) stresses that patients who follow dietary prescriptions are more likely to control their blood pressure and have a more effective chronic kidney disease management.
Race also has certain effect on development of chronic kidney disease and hypertension. Thus, Kauric-Klein (2013) states that race has an impact on the way people control their treatment and nutrition. Thus, it is found that African Americans are characterized by skipping and shortening of HD treatments (Kauric-Klein, 2013, p. 978). At this point, it is necessary to note that correlation between race and development of hypertension and chronic kidney disease has not been identified and further research is necessary.
Likewise, gender also has certain effect on the course of the disease. Females tend to be more responsible and control their fluid consumption and follow all the necessary prescriptions (Kauric-Klein, 2013). Again, it is not clear whether gender has a significant impact on development of the disorders. However, when it comes to treatment, the correlation has been identified.
As far as nutrition and life style are concerned, there is quite definite link between them and development of the disorders. People who have inappropriate lifestyles (eat a lot of harmful food, have little exercise and so on) are at a higher risk of development of hypertension and chronic kidney disease.
Prevention and Treatment
Prevention and treatment of hypertension and chronic kidney disease are still disputable. López-Novoa et al. (2010) focus on medication, gene and cell therapies. The researchers state that these are the most advanced and effective ways to treat the diseases in question. The authors mention some drugs that have proved to be effective. The pay special attention to potential use of cell and gene therapy. López-Novoa et al. (2010) admit that the latter two types of treatment are still on the stage of development but they stress that there have been many promising findings in the field.
As has been mentioned above, improper nutrition often leads to development of the diseases. Clearly, proper nutrition may be an effective preventive measure as well as an efficient supplementary treatment strategy. It has been acknowledge that control over liquid consumption among patients with chronic kidney disease and hypertension positive affects their health condition.
Finally, proper lifestyle is another important treatment and prevention strategy that can be employed. Smart et al. (2013) note that moderate aerobic exercise has proved to be effective in patients with chronic kidney disease and hypertension. The researchers stress that training should be developed by professionals who take into account all health conditions of the patient. There are also certain contraindications to exercise. For instance, if a patient has electrolyte abnormalities, peripheral oedema and some other disorders, training cannot be assigned. It is also noted that the change of the medication regime as well as certain issues with dialysis treatment can be a contraindication to exercise. Likewise, Howden et al. (2013) note that aerobic exercise can be controversial and it is essential to pay attention to all health conditions of the patient prior to development of a training program. At the same time, the researchers stress that exercise can be seen as an effective treatment and preventive strategy that can be utilized when treating patients with chronic disease and hypertension.
Conclusion
In conclusion, it is possible to note that there is significant amount of works on the link between chronic kidney disease, risk factors causing the diseases as well as treatment and preventive measures. Researchers have identified that there is certain link but there are certain gaps in this sphere. Major risk factors have been pointed out but there is not sufficient evidence as only one risk factor is identified clearly. As for the rest of the risks identified (gender, race, lifestyle, dietary habits), there are quite controversial data and, hence further research is needed. Finally, treatment and prevention measures have received considerable attention in the literature, however, the data provided need to be checked and more facts should be found.
Reference List
Howden, E.J., Leano, R., Petchey, W., Coombes, J.S., Isbel, N.M., & Marwick, T.H. (2013). Effects of exercise and lifestyle intervention on cardiovascular function in CKD. Clinical Journal of the American Society of Nephrology, 8(9), 1494-1501.
Kauric-Klein, Z. (2013). Predictors of nonadherence with blood pressure regiments in hemodialysis. Patient Preference and Adherence, 7, 973-980.
López-Novoa, J.M., Martínez-Salgado, C., Rodríguez-Peña, A.B., & López Hernández, F.J. (2010). Common pathophysiological mechanisms of chronic kidney disease: Therapeutic perspectives. Pharmacology & Therapeutics, 128(1), 61-81.
Smart, N.A., Williams, A.D., Levinger, I., Selig, S., Howdene, E., Coombes, J.S., & Fassett, R.G. (2013). Exercise & Sports Science Australia (ESSA) position statement on exercise and chronic kidney disease. Journal of Science and Medicine in Sport, 16(5), 406-411.
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