The relationship between resistant hypertension, diabetes and kidney disease

Resistant Hypertension is the second leading cause of kidney failure or end stage renal disease. If the kidneys fail, dialysis or a kidney transplant is necessary.

Diabetes and high blood pressure can also cause nephrotic syndrome when the kidneys are not working correctly and protein which normally stays in your blood gets removes along with waste in your urine. Your body needs protein since it acts like a sponge in your blood and holds fluid that your body needs inside your arteries and veins. If there is not enough protein, this fluid can leak into other tissues in your body causing swelling.

High blood pressure and diabetes are the ”silent killers”

These two are the “silent partners” in kidney disease. They are “silent” because many people do not know they have these diseases and are not getting the treatment they need. Together, diabetes and high blood pressure account for two/thirds of all cases of chronic kidney disease.

Because so many people do not know they have high blood pressure or diabetes, two

of the biggest risk factors for kidney disease, and they may not have any symptoms of kidney disease, they may already have kidney disease and do not know it.

Regular checkups with screenings for blood pressure and glucose levels, and other blood, urine and imaging tests can help diagnose both hypertension and diabetes as well as any kidney disease.

High blood pressure

High blood pressure results in extra fluid in your body and increases the fluid in your blood vessels, making your blood pressure even higher. In addition to extra fluid, narrowed or clogged blood vessels can raise your blood pressure.

When blood pressure is very high and left untreated, it can damage the blood vessels that carry blood throughout the body. The smaller blood vessels are the ones usually affected first. Kidneys have small blood vessels that can become damaged by high blood pressure, leading to kidney disease.

High blood pressure makes your heart work harder, and over time, can damage blood vessels all over your body. If the blood vessels and filters in your kidneys are damaged, they may stop removing wastes and excess fluid from your body and the excess fluid may raise your blood pressure even higher. It becomes a dangerous cycle.

You should know your number. High blood pressure is consistently a systolic (top number) 140 or higher and a diastolic (bottom number) of 90 or higher.


This is a disease in which your body does not make enough insulin, a hormone that regulates the amount of sugar in your blood, or cannot use normal amounts of insulin properly. A high blood sugar can cause many problems throughout the body. High levels of sugar in the blood damage the millions of tiny filtering units within each kidney.

People with diabetes are also at risk for other kidney problems such as narrowing of the arteries to the kidneys, called renal artery stenosis. Over time, high sugar levels in the blood can cause the vessels to become narrow and clogged.

With diabetes, the small blood vessels in the body are injured and when the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling.

As the filters and blood vessels are damaged, kidney function worsens and protein may leak out of your kidneys into your urine and waste materials will build up in your blood. Diabetes can also damage your nerves, making it more difficult to empty your bladder.

The pressure from your full bladder can back up and injure your kidneys. Also, if the urine remains in your bladder a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.

Have your blood pressure and blood glucose levels tested regularly and see a kidney specialist if you experience fluid retention in your legs, ankles, feet or face; have unexplained fatigue, headache, nausea or vomiting.

To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (1.866.225.5654) or use our secure online appointment request form.