Most people think kidney disease is a sudden and random health problem. However, it does the opposite, creeping in quietly without showing obvious symptoms until it’s too late. By the time you get a diagnosis, you will notice the significant damage caused.

According to research, hypertension (high blood pressure) and diabetes are the leading causes of chronic kidney disease. They account for the majority of cases with kidney failure, which often require dialysis or kidney transplants. Read on to discover why hypertension and diabetes are the leading causes of kidney disease.

An Overview of Kidney Function

Most people are born with two kidneys located at the back of the abdomen. These bean-shaped organs offer support for the most complex waste filtration system in your body. This is why even minor cases of disrupted blood pressure or sugar levels can cause long-lasting and severe damage.

Kidneys perform several vital functions, including:

• Filtering waste products and excess fluids from the blood.
• Regulating electrolytes like sodium, potassium, and calcium.
• Controlling blood pressure through hormone release.
• Stimulating red blood cell production.
• Maintaining bone health.

How Hypertension Damages the Kidneys

When you have high blood pressure, the blood vessels are narrowed, or your heart is under constant stress to pump more blood. The force of blood pushing against the walls of your blood vessels can lead to damage in the kidneys, specifically in the glomeruli, which are responsible for filtering waste from your blood.

The damage to the kidneys happens in these most common ways:

1. The prolonged high blood pressure causes the kidney arteries to become stiff and narrow, thereby reducing blood flow through the kidneys.
2. Persistent pressure damages the filtering units, leading to scarring (nephrosclerosis) of the kidney.
3. As more glomeruli are scarred, the kidneys’ ability to filter waste declines, leading to chronic kidney disease.

How Diabetes Damages the Kidneys

Diabetes, particularly poorly controlled type 1 and type 2, is the single most common cause of kidney disease worldwide. The constant presence of excess glucose in the blood damages blood vessels and tissues throughout the body, including in the kidneys. Diabetic kidney disease often begins silently and may not cause symptoms until kidney function is significantly reduced.

These are the typical mechanisms of kidney damage from diabetes:

1. High glucose levels lead to chemical changes in proteins in blood vessels, making them less flexible and more prone to damage.
2. Thickening of the glomerular basement membrane, a structural change which reduces kidney function.
3. Damaged filtering units allow proteins, such as albumin, to leak into the urine, one of the earliest signs of diabetic kidney disease.
4. Over the years, the damage accumulates, leading to kidney failure.

What Happens When Hypertension and Diabetes Overlap?

Hypertension and diabetes commonly occur side by side. Most people diagnosed with type 2 diabetes often develop high blood pressure. However, this is a life-threatening combination of chronic conditions because they can contribute to:

• Accelerated blood vessel damage which can worsen the strain on those vessels.
• The combined effect multiplies the risk of developing kidney disease faster and progressing more aggressively.
• Together, they are responsible for up to 70% of all cases of end-stage kidney disease (ESKD) requiring dialysis or transplantation.

Warning Signs of Kidney Disease

Since kidney disease often progresses silently, it is essential to be aware of some warning signs that should not be ignored. Most importantly, because by the time symptoms appear, the damage would have most likely advanced. Screening for kidney damage is important if you notice:

• Swelling in the feet, ankles, or around the eyes due to fluid retention.
• Foamy or bubbly urine which may indicate protein leakage.
• Fatigue and weakness may be caused by anaemia resulting from reduced kidney hormone production.
• High blood pressure that becomes harder to control.
• Frequent urination at night (nocturia).

How to Protect Your Kidneys and Manage Severe Kidney Damage

The good news is that kidney disease caused by hypertension and diabetes can be prevented or slowed down with proper management.

1. Control Blood Pressure

Aim for a blood pressure reading below 130/80 mmHg, which is recommended for individuals at risk of kidney disease. Use prescribed medications to protect the kidneys. Moreover, reduce your salt intake to ease the strain on blood vessels.

2. Manage Blood Sugar Levels

Following a diabetes-friendly diet with a controlled carbohydrate intake can make a difference. Additionally, using your Affinity Health plan for regular screenings to ensure your average blood sugar levels are below a specific percentage at least every 3 months is recommended. If you face insulin-related challenges, ensure you have the proper prescribed medications to manage them effectively.

3. Maintain a Kidney-Friendly Lifestyle

• Drink enough water, but avoid excessive fluid intake.
• Quit smoking, which accelerates blood vessel damage.
• Exercise regularly to improve blood pressure, glucose control, and manage your weight.
• Avoid the overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), which can harm the kidneys.

4. Regular Screening and Monitoring

If you have hypertension or diabetes, you should undergo annual kidney function tests, including a urine albumin test to detect early protein leakage, as well as a serum creatinine and eGFR test to measure kidney function. Early detection means treatment can begin before irreversible damage occurs.

Lifestyle habits and existing medical conditions can increase your risk of developing hypertension and diabetes. The prolonged damage of blood vessels and a dysregulation of the waste filtration system can create a pathway that often leads to chronic kidney disease, which can result in fatal kidney failure. An Affinity Health Combined Plan gives you the best of both worlds, providing unlimited, managed GP consultations, blood tests, and the necessary hospitalisation benefit should your condition require appropriate in-hospital diagnostic procedures.