Introduction
Studies indicate that high blood pressure is a frequent occurrence among the patients with both acute and chronic kidney disease (Hilgers & Mann, 2014; Mann, 2014; Tedla et al., 2011). Such studies also indicate that hypertensions have been found to occur mostly among patients with glomerular or vascular disorders (Tedla et al., 2011). The therapies of the disorders vary depending on the condition of the patients and the level of the blood pressure (Mann, 2014). The management and treatment of the hypertension remain critical determinant of the survivability and final treatment of the patients suffering from chronic kidney disease (Tedla et al., 2011). The evidences presented in such studies provide a direct correlation between hypertension and the chronic kidney disease. Besides, the evidence of such studies has been used to develop therapies and preventive measures among the medical practitioners.
How Research have linked Hypertension and Chronic Kidney Disease
Studies indicate that patients with hypertension are likely to develop chronic kidney disease (Tedla et al., 2011; Hilgers & Mann, 2014; Mann, 2014). In fact, hypertension is both the source and result from the chronic kidney disease (Tedla et al., 2011). Evidence suggests that the management and prevention of chronic kidney disease benefit from the high blood pressure control (Kauric-Klein, 2012). On the other hand, clinical trials demonstrate that CKD is more likely to cause high blood pressure given the importance of kidneys in the control of glucose levels in the blood (Scheffers, Kroon, Schmidli, 2010). Even though the studies have linked the CKD and hypertension, the results are limited to clinical group of disorders. In fact, whether the results can be extrapolated to include other chronic kidney disorders remains a matter of clinical trials. Chronic kidney diseases include a large number of clinical disorders characterized by their heterogeneous causative agents and natural history (Scheffers et al., 2010; Tedla et al., 2011). In fact, most of the studies on the relationship between hypertension and chronic kidney disease have not taken into consideration patients with kidney failure (Scheffers et al., 2010).
While results from clinical trials indicate that appropriate treatment of CKD has increased probability of reducing uncontrolled high blood pressure, the prevalence rate of hypertension is still increasingly high among patients with CKD. Further, the findings indicate that the control and treatment of the disease are far from being attained despite the mounting evidence. Studies indicate that in the United States, the prevalence rate of adults with hypertension is about 23% of non-CKD patients (Mann, 2014). Based on the results of the national survey of non-institutional adults in the United States, about 35% of stage 1, 48% of stage 2, 60% of stage 3 and 84% of stage 4 and 5 of the CKD patients are suffering from hypertension (Mann, 2014). Besides, the results indicate that the prevalence of hypertension also depends on the cause of CKD. Hypertension is strongly correlated to patients with the Renal Artery Stenosis (RAS), Diabetic Nephropathy (DN) and the Polycystic Kidney Disease (PKD) represented by about 93%, 87% and 74% respectively (Mann, 2014). Hypertension is common among patients on both peritoneal dialysis and hemodialysis as well as among the patients who have experienced renal transplant (Mann, 2014). However, the technical understanding and definition of hypertension influences the manner in which hypertension has been correlated with peritoneal dialysis and hemodialysis (Kauric-Klein, 2012b).
In spite of the increased prevalence of hypertension among patients with CKD as well as the availability of medication, only a few patients attain the goals of the prescribed therapy (Hilgers & Mann, 2014). However, evidence suggests that the prevailing circumstances are changing in the general population (Jones, 2014; Kauric-Klein, 2012b). The evaluations of the current studies and those of earlier decades indicate that increased awareness of the control of hypertension has caused the improvement of the patient outcomes (Jones, 2014; Kauric-Klein, 2012a; Samranbua, 2011). Besides, the current studies indicate that the evidence-based treatments of other cardiovascular treatments among the patients with CKD have also caused the improvement of the patient outcomes (Jones, 2014; Kauric-Klein, 2012a). However, the reduced rates compared with the earlier decades indicate that increased awareness among the CKD patients have yielded positive results (Jones, 2014; Kauric-Klein, 2012a; Scheffers et al., 2010). Critical analysis of the results of the current studies also indicates that the increased awareness have also resulted in reduced non-adherences to the prescribed therapies (Scheffers et al., 2010). Even though such studies are not clear on the type of hypertension among the CKD patients, the results highlight the significant roles of the nurses in monitoring and reliably diagnose hypertension as well as assess the achievement of high blood pressure goals (Scheffers et al., 2010).
Conclusion
While most studies on the relationship between hypertension and the CKD have focused on the treatment, the researches on how hypertension can be managed to reduce the chances of mortalities among the CKD patients are lacking. Besides, researchers have not accurately determined whether high blood pressure results in the CKD. Moreover, despite the prevalence rate of hypertension among patients with CKD as well as the availability of effective medication, only a few patients attain the goals of the prescribed therapy. However, the current studies indicate improved patient outcomes due to the increased awareness on the prevention and management of hypertension among the patients with CKD.
References
Hilgers, K. F. & Mann, J. F. (2014). Effect of antihypertensive treatment on renal function in primary (essential) hypertension. American Journal of Nephrology, 36(3), 456-498.
Jones, L. (2014). Reducing disparities in hypertension among African-American women through understanding information seeking and information use (Doctoral dissertation). Web.
Kauric-Klein, Z. (2012a). Blood pressure knowledge in hypertensive hemodialysis patients. Canadian Association of Nephrology Nurses and Technologists Journal, 22(4), 18-25.
Kauric-Klein, Z. (2012b). Improving blood pressure control in end stage renal disease through a supportive educative nursing intervention. Nephrology Nursing Journal, 39(3), 217-228.
Mann, J. F. (2014). Pathogenesis of hypertension in kidney disease. American Journal of Nephrology, 36(2), 398-427.
Samranbua, A. (2011). The Lived Experience of Rural Thai Older Adults with Poorly Controlled hypertension (Doctoral dissertation). Retrieved from ProQuest Dissertations and Theses.
Scheffers, I. J.M. Kroon, A. A. Schmidli, J. (2010). Novel baroreflex activation therapy in resistant hypertension: results of a European multi-center feasibility study. Journal of the American College of Cardiology, 56(15), 1254–1258.
Tedla, F. M., Brar, A., Browne, R. & Brown, C. (2011). Hypertension in chronic kidney disease: navigating the evidence. International Journal of Hypertension, 1(1), 332-405.