Hand with heart and kidney

18 June, 2018

Published in: Today Digital
Author: Dr. Belkis Almánzar, Clinical Cardiologist. Cardiology Management of the General Hospital of the Plaza de la Salud.

Hypertension is one of the most frequent chronic diseases worldwide and affects 31% of the population in our country according to the latest survey conducted recently by the Dominican Society of Cardiology. This can cause damage to vital organs such as heart, brain and kidney, among other organs. On the other hand, chronic kidney disease (CKD) is considered a serious health problem worldwide, which does not escape our country, because to its social and economic consequences. Multiple studies have shown the direct relationship between the control of blood pressure and the risk of developing CKD, independently of age, race, income, cholesterol levels, smoking and the treatment of diabetes.

The prevalence of CKD has increased due mainly to the increase in the incidence of diabetes and hypertension, as well as the aging of the population.

Hypertension is a factor that is related to the onset of kidney damage and at the same time to its progress.

The kidneys play a key role in keeping blood pressure within its normal parameters, but the pressure can affect the health of the kidneys, altering the function and morphology of the kidneys; It can cause kidney failure, a condition that can lead to dialysis or death.

The kidney is able to modulate blood pressure changes, since it has mechanisms capable of modifying the hemodynamic factors that sustain it, such as volume and peripheral resistance.

Schematically, the kidney controls the volume of fluid within the cell, as well as the balance of sodium or salt by modifying its excretion by different mechanisms. The relationship between chronic salt intake and arterial hypertension exists, being demonstrable when studying communities with different habits and consequently with very variable salt consumption.

Several studies show that some subjects raise their blood pressure more by varying the salt intake, so they qualify as salt sensitive hypertensive.

In addition, sensitivity to salt seems to be linked to factors such as age, female sex and black race.

In hypertension there is an abnormal relationship between pressure-excretion of salt. This suggests that, in the kidney, the mechanisms of sodium resorption would probably be activated by vascular alterations of constriction of the artery or by renal alterations of their own.

The hypertension induced by renal diseases is the most frequent cause of secondary hypertension, so that 10 to 40% of the nephropathies without insufficiency or little renal failure, would have arterial hypertension.

When kidney failure is severe, hypertension is present in 80% of cases.

In addition, the presence of arterial hypertension left to its evolution accelerates the course towards terminal renal failure.