High Blood Pressure and Kidney Disease: How Each Can Harm the Other

High blood pressure and kidney disease are closely tied: high blood pressure can be both a cause and a result of kidney disease [1][2]. As the US Centers for Disease Control and Prevention (CDC) puts it, "Either condition can lead to or worsen the other." [2] Managing your blood pressure can help prevent kidney damage [3], and because neither problem tends to cause symptoms early on [1], getting your blood pressure checked matters [4][5].

How Your Kidneys Work

Your kidneys sit on either side of your spine. Their main job is to keep water and electrolytes balanced in the body, and they filter the blood, removing waste and extra fluid [3][6]. Delicate blood vessels inside the kidneys do this filtering [3].

How High Blood Pressure Damages the Kidneys

High blood pressure can constrict and narrow blood vessels throughout the body, including those in the kidneys, which eventually damages and weakens them and reduces blood flow [1][2]. When the kidneys' blood vessels are damaged, the kidneys may stop working properly and can no longer remove all the waste and extra fluid from the body [1][7].

Over time, uncontrolled high blood pressure can cause the arteries in and around the kidneys to narrow, weaken or harden, so the kidneys do not receive the oxygen and nutrients they need to work well [3]. It can also lead to scarring of kidney tissue, which can impair how the kidneys filter blood and regulate fluid and electrolytes [3]. This damage can lead to decreased kidney function over time [2], and kidney failure due to high blood pressure can take years to develop [3].

How Kidney Damage Pushes Blood Pressure Up

The link also runs the other way. When the kidneys are damaged and cannot filter blood properly, extra fluid and waste stay in the body, and this can cause other health problems, including high blood pressure [1][2]. Extra fluid in the blood vessels can raise blood pressure even more, creating a dangerous cycle, and cause more damage, which can lead to kidney failure [1].

Hormones play a part too. Healthy kidneys respond to a hormone called aldosterone, which has an important role in regulating blood pressure throughout the body, and damaged kidneys fail to regulate blood pressure [3]. Blood pressure can become more difficult to control in people with kidney damage, and uncontrolled high blood pressure can in turn contribute to worsening kidney damage, a harmful cycle [3].

This is why high blood pressure appears among the possible complications of chronic kidney disease (CKD) [6], and why kidney disease is among the conditions that raise the risk of developing high blood pressure [5].

How Common Kidney Damage From High Blood Pressure Is

In the United States, high blood pressure is the second leading cause of kidney failure after diabetes [1] and one of the leading causes of CKD [2]. Approximately 1 in 3 adults with diabetes, and 1 in 5 adults with high blood pressure, may have chronic kidney disease [2].

High blood pressure is common worldwide. An estimated 1.4 billion adults aged 30 to 79 years worldwide had hypertension in 2024 [5]. When it is too high, it puts extra strain on the blood vessels, the heart and other organs, including the kidneys, and if it is not treated it can lead to serious conditions such as kidney disease, heart disease and stroke [4][5].

Who Is More Likely to Develop Kidney Problems

Anyone with high blood pressure can develop kidney damage, but some things add to the risk. The longer you have had high blood pressure, diabetes, or heart and blood vessel disease, the more likely you are to develop CKD [6]. Besides high blood pressure, factors that increase the risk of kidney disease include diabetes and a family history of kidney failure [1]. In the US, African Americans, Hispanics and American Indians tend to have a greater risk for CKD [1].

High blood pressure itself becomes more likely as you get older and when it runs in your family [1][4][5]. Habits that raise the risk include eating a lot of salt, drinking too much alcohol and not being physically active [1][5], and being overweight and smoking add to it [4][5]. Feeling stressed over a long period can also play a part [4].

In the US, high blood pressure is more common in African American adults than in Caucasian, Hispanic or Asian adults, and men are more likely to develop it before age 55 and women after age 55 [1]. In the UK, the risk is higher for people with a Black African, Black Caribbean or South Asian ethnic background [4].

Why You May Not Notice Anything

Most people with high blood pressure have no symptoms [1][4][5], although in rare cases it can cause headaches [1]. Early kidney disease usually causes no symptoms either [1][7]. As kidney disease gets worse, some people may get swelling, called edema [1].

Getting Checked

Your blood pressure. The only way to find out whether you have high blood pressure is to have it checked [4][5]. The test involves inflating a cuff around your upper arm, and it is quick and painless [4][5]. You can also buy a cuff to check your blood pressure at home [1], but an evaluation by a health professional is still important to assess your risk and any related conditions [5]. It helps to know your own blood pressure numbers [3].

In the UK, the NHS advises getting your blood pressure checked at a pharmacy or GP surgery in these situations [4]:

• you think you might have high blood pressure, or might be at risk of having it
• you are aged 40 or over and have not had your blood pressure checked for more than 5 years

Your kidneys. For many people, blood and urine tests are the only way to know whether they have kidney disease [6][8]. If you have high blood pressure, you may be advised to have regular kidney tests so that any problem is found at an early stage, so ask your doctor how often you should be tested [8][7]. The checks are a blood test that shows how well your kidneys are filtering your blood, called GFR (glomerular filtration rate), and a urine test for albumin, a protein that can pass into the urine when the kidneys are damaged [1][8].

Protecting Your Kidneys

The best way to slow or prevent kidney disease from high blood pressure is to take steps to lower your blood pressure [1][3]. These steps combine lifestyle changes with medicines for those who need them [1][5]. Lowering your blood pressure even a small amount can help reduce the risk of problems such as kidney disease [4].

Lifestyle steps that help lower blood pressure include:

• Being physically active [1][2][5].
• Eating a healthy diet, with plenty of fruits and vegetables and less salt [1][2][5].
• Keeping a healthy weight [1][5].
• Not smoking, or quitting if you smoke [1][2][4][5]. Smoking can damage blood vessels, raise the chance of developing high blood pressure and worsen health problems related to it [1].
• Managing stress [1][5].

If you have a long-term condition that could lead to kidney disease, such as high blood pressure, it is important to manage it carefully: follow your doctor's advice, take any medicine you are prescribed and keep your appointments [9][5]. It is also worth talking to your doctor about medicines that can harm your kidneys and about ways to lower your blood pressure [2].

The benefits reach beyond the kidneys. Managing your blood pressure, blood sugar and cholesterol can reduce your risk of heart disease and stroke as well as CKD [2][5].

If You Already Have Kidney Disease

Whatever caused your kidney disease, high blood pressure can make it worse [1]. The US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) advises: "If you have kidney disease, you should talk with your health care professional about your individual blood pressure goals and how often you should have your blood pressure checked." [1] The blood and urine tests used to check for kidney disease are also used to monitor it over time [1][8]. A registered dietitian can help tailor your diet to your kidney disease, and people with advanced kidney disease should speak with their health care professional about what they eat [1].

When to Get Help

In the UK, the NHS says: "Get help from NHS 111 if:" [4]

• "you often have headaches or blurred vision"
• "you have chest pain that comes and goes"
• "you have other symptoms you're worried could be caused by high blood pressure"

"You can call 111 or get help from 111 online." [4]

In the UK, the NHS also says: "Call 999 if:" [4]

• "you get sudden pain or discomfort in your chest that does not go away - the pain can feel like squeezing or pressure inside your chest, burning or indigestion"
• "you get pain that spreads to your left or right arm, or your neck, jaw, stomach or back"
• "you have chest pain and you feel sweaty, sick, light headed or short of breath"

"You could be having a heart attack. Call 999 straight away as you need immediate treatment in hospital." "Do not drive yourself to A&E." [4]

In the UK, see a GP if you have persistent or worrying symptoms that you think could be caused by kidney disease [7].

Conclusion

High blood pressure and kidney damage can reinforce each other over years, often without obvious symptoms. Knowing your blood pressure is the starting point. If it is high, asking your doctor about kidney tests and about ways to bring your blood pressure down can help protect your kidneys, heart and overall health.

Medical Disclaimer

This article is for general information and does not replace advice from a qualified health professional. If you think you need urgent medical care, get emergency help straight away.