Etiology of High Blood Pressure in PKD

In most cases of Polycystic Kidney Disease (PKD), high blood pressure is the first symptom. It is an immediate cause of heart failure and other complications among the patients. Sometimes, the patients with PKD may die of other diseases due to high blood pressure before it progresses into End Stage Renal Failure. Therefore, it is very important to manage high blood pressure in PKD.

High blood pressure is a sign of disease aggravation. For more than 50% of the patients with PKD, their blood pressure rises before the creatinine level elevates. PKD is featured by multiple cysts growing on kidneys. If left untreated, the cysts will enlarge continuously and oppress the healthy renal tissues and renal blood vessels causing renal local ischemia. After the receptor in kidneys senses this case, it can stimulate the kidneys to secrete more renin.
As a result, the angiotensin concentration rises and blood vessels contract. Afterwards, the blood pressure will increase. High blood pressure and renal function damage forms a vicious circle.

After the blood pressure rises, the small arteries through the body will contract and have spasm, which can cause the endangium to have hyaline change and damage the vascular wall. Afterwards, more cholesterol and other substances will deposit on the vascular wall and thicken the vascular wall and thin the lumen. As a result, the renal fibrosis is initiated and kidneys fail gradually until develops End Stage Renal Failure.

Then what can be done to control high blood pressure in PKD?

High blood pressure can be lowered by life style changes, regular exercise and diet. They should avoid smoking and alcohol and develop healthy daily habits. Increased salt intake can cause water retention in body thus increasing blood volume elevating blood pressure.

If there is a family history of PKD, other family members should keep systemic screening and keep the principle: early inspection and early treatment. In this way, they will be able to reduce the incidence of Renal Failure.