How rapid can hypertension causes kidney disease

[quart]

Hi,

Two and a half year ago I was still diagnosed as having prehypertension and the blood test show that the BUN, creatinine, and BUN/CREAT ratio were all basically in the middle of the acceptable range. Late last year I was diagnosed as having hypertension (perhaps it went undetected for 1 1/2 year because I thought I was having prehypertension and taking hydrochlorothiazide on and off as needed.) and is taking lisinopril/hydrochlorothiazide combination drug. I am scheduled to take a blood test soon. Having read about kidney disease and its symptoms (or not) in the last few days, I am afraid that I might have developed kidney disease. I basically can be considered to have no symptoms at this point (or I can not definitely say that I have one or two symptons). How likely (in terms of percentage if possible) that I have early stage kidney disease already. I am already very worried so I want to have an idea of this likelihood because I have to wait about 2 weeks. I want to spend the next 2 weeks worry the proper amount so I would appreciate some viewpoints to help me through. Thanks!

[John Kenyon, CNA]

Hello -

While you haven't defined in your post what was considered to be pre-hypertension (in terms of average and peak blood pressures), if the BP is at or below 130/80 then it is considered controlled. Hypertension damages various persons' kidneys at varying rates, so even if there were a useful per centage or other statistical answer to your question, it would only apply to the broad category and not to you specifically. I am unaware of any statistic which would give the answer you're seeking. I do know the damage occurs over the course of years, and if you're not hypertensive (that is, if your normal, resting blood pressure is at or below 130/80 then you're not at risk of kidney disease.

I think the "proper amount" of worry would be the amount that would be compatible with a relatively low-stress existence, which would in turn help maintain healthy, normal blood pressure. One doesn't go into end-stage kidney disease over night, and if you've been monitoring your blood pressure and it's not out of control then the best thing you can do for yourself is to take life one day at a time and educate yourself as to what will best maintain your good health. If you're being treated for high blood pressure and it's being managed well, then you have every reason to expect a good result from your blood tests. If not, then the testing is certainly prudent in order to keep track of the function of your kidneys, nothing more than that. Taking a positive and pro-active stance toward one's health and health problems is always going to yield the best outcome. Statistics can be very dangerous.

I hope this is helpful to you. Best of luck with the tests, and please follow up here as needed. Update us, by all means, once you've gotten your results.

[quart]

Hi,

Thanks for advice. I have gotten my blood test results and to my relief my kidney function appears to be OK. However I read that even if the GFR is greater than 90 but if there is protein in the urine then I am considered to have stage 1 chronic kidney disease. Considering the following results in my blood test, how likely am I to have abnormal amount of protein in my urine? Can blood test results correlate with urine test results?

BUN 11 mg/dL
Creatinine .81 mg/dL
BUN/Creatinine Ratio 13.6
Total Protein 7.9 g/dL
Albumin 4.9 g/dL
ALB/GLOB Ratio 1.6

Thanks again!

[John Kenyon, CNA]

You're welcome. Your labs (as reported) are all normal, which is of course what we want to see. It's not always possible to correlate serum protein with urine protein, because protein can find its way through the kidneys, where there might be a problem, but not in quantities sufficient to drop the serum level. In fact, there are a number of condions which may cause proteinuria, kidney disease merely being the most common of them. Mere presence of protein in the urine is not de facto evidence of kidney disease, but some standards are highly technical and will call this "stage I kidney disease" even if it's not actually due to kidney failure, because it then must be considered. It's not, strictly speaking, correct, however.

Chronic protein in the urine does mean one has proteinuria, which simply is another way of saying there is (chronically) protein found in the urine. If it is low levels there will likely not be any symptoms, but there is still reason to try and uncover the underlying cause. Again, serum levels tell part of the story (that kidneys are functioning well), but cannot rule out proteinuria because blood is not urine.

I hope this answers the question. Good luck with this and please keep us updated.