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  Tuesday, 26 March 2013
  2 Replies
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When a patient comes with CKD of unknown aetiology and Hypertension how do we know that the CKD is due to Hypertension or vice versa?
11 years ago

That's a good question without an easy answer.

Renal dysfunction that results from hypertension will be predated by a history of long-standing hypertension, and is often accompanied by other risk factors for vascular disease (diabetes, atherosclerosis, smoking). It is often indolent in nature an lacks heavy proteinuria (unless blood pressure is poorly controlled).

Acute onset kidney disease (due to glomerulonephritis for example) can lead to kidney dysfunction of course, and in that context, can also lead to hypertension. These patients may not have any history of long-standing hypertension (although they may - as glomerulonephritis can also happen in people with hypertension but not related to it).

Chronic kidney disease (say from polycystic kidney disease) could eventually lead to hypertension and its diagnosis might even predate the hypertension. But in this case, one would usually know about the renal disease first.

Often, when one can no other cause of renal disease, yet the patient has hypertension and no significant proteinuria, these patients are often labelled as having atherosclerotic kidney disease, ischemic nephropathy or sometimes hypertensive nephrosclerosis (those the last term usually is accompanied by significant proteinurua).

Dr. Jordan Weinstein
11 years ago
Thanks a lot...
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