Hypertension and Kidney Disease Learning Objectives

Question 1

Explain the relationship between hypertension and kidney disease.

Answer 1

• genetic mutation in populations that cause hypertension due to abnormal kidney funcion
• excess secretion of aldosterone lead to increase in NA+ absorption in nephrons= sodium increase, ECVF increase and hypertension develops

Question 2

Name risk factors that contribute to hypertension

Answer 2

• genes
• people of African decent at higher risk
• inherited defects associated with renal excretion of NA+, insulin and insulin sensitivity, activity of the renin, angiotensin, aldosterone system

Question 3

Name clinical interventions to control hypertension

Answer 3

• quit smoking
• maintain a healthy weight
• exercise properly
• early diagnosis
• prehypertension and stage 1- lifestyle modifications
• weight loss
• exercise
• relaxation

Question 4

Identify the public health burden of hypertension and chronic kidney disease

Answer 4

• many people d not have access to good health care
• many people do not know if they are sick with either hypertension or kidney disease
• cost issues
• poor quality of life
• lack of strategies: target economic, political and environmental factors

Question 5

Name prevention strategies for hypertension and kidney disease.

Answer 5

• low-sodium diet
• low fat diet
• exercise/ mediate
• medication
• potassium restriction
• salt/water balance
• better screening

Question 6

Explain the pathophysiology of kidney disease.

Answer 6

• injury or loss of nephrons
• dilation of afferent and efferent arteries
• increased PRESSURE in GLOMERULI (hyperfiltration, mechanical stretch of cells, inflammation)
• injury to remaining nephrons

Question 7

Name some clinical manifestations of kidney disease

Answer 7

• azotemia (INCREASE SERUM and DECREASED KIDNEY FUNCTION)
• uremia (HYPERTENSION, CVD, EDEMA, etc)
• skeletal damages
• acidosis (EXCESS ACID)
• H2O RETENTION

Question 8

What is the equation for Pressure?

Answer 8

Pressure= FLOW X RESISTANCE

Question 9

What happens during the “flow” in pressure?

Answer 9

the flow affects the SYMPATHETIC NERVOUS SYSTEM because it INCREASES HEART RATE and the “FIGHT OR FLIGHT RESPONSE” increases blood flow

Question 10

What happens during “resistance in pressure?

Answer 10

• increases resistance

- constricts blood vessels

Question 11

Explain the effect in flow of blood in hypertension and kidneys.

Answer 11

increased in BP-> damage in glomeruli-> protein release-> inflammation (repeat cycle)