What Is Hypertensive Nephropathy?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 26 October 2018
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Hypertensive nephropathy is kidney dysfunction caused by persistent high blood pressure. This is a common form of renal disease and is a frequent cause of damage so severe that the patient requires renal dialysis to take over for failing kidneys. There are some measures available to prevent hypertensive nephropathy, or to address the damage early to improve quality of life for the patient. It may be necessary to visit a renal specialist to get a review of the most current and effective treatment options.

Chronic high blood pressure puts great strain on blood vessels, especially in areas like the kidneys where the rate of blood flow is very high. Over time, the vessels that supply the kidneys with blood can thicken and harden. This limits the flow of blood into the kidneys and causes a condition called ischemia, where tissues start to die because they do not get enough oxygen. Not only do the kidneys have trouble filtering blood quickly enough because of the reduced flow, but their function also declines because of the tissue death.


Patients at risk for hypertensive nephropathy are usually easy to identify. They have consistently high blood pressure and may experience other health problems in addition to kidney issues, because hypertension is also hard on the heart and lungs. Such patients may benefit from measures to reduce blood pressure, including diet and exercise modifications as well as medications to force the pressure down. If the patient doesn't adhere to treatment or does not respond, the risk of complications like hypertensive nephropathy can increase.

This condition can cause a variety of symptoms including thirst, swelling, and changes in urine output. As the kidneys start to fail, patients can feel fatigued and may develop abnormal blood chemistry. Blood and urine samples can provide information about what is going on inside the body. They may show the tell-tale signs that the kidneys are having trouble filtering the blood efficiently. Medical imaging and biopsy may be necessary to pinpoint the kidney damage and determine the level of severity. Care providers use this information to make effective treatment recommendations.

Renal dialysis, where an external machine takes over for the kidneys, may be necessary to treat hypertensive nephropathy. The patient may also benefit from some measures to lower blood pressure to reduce the strain on the kidneys and other organs. Long-term options can depend on how well the patient responds to treatment, and how early the damage is caught. In some cases, a kidney transplant may be necessary to replace a failing organ. Regular dialysis treatments while waiting for a transplant can keep the patient as stable as possible.



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