In managing blood pressure, patients with membrane kidneys need to be particularly careful, as high blood pressure is not only a common complication of membrane kidney disease, but also increases kidney damage and accelerates the progress of the disease.
I. Relationship between blood pressure and kidney disease
Blood pressure means the pressure on the vascular wall when the heart shrinks and stretches. Long-term high blood pressure increases the internal pressure of the kidney ball, damages the renal ball and filters, resulting in increased protein urine and reduced kidney function. For patients with membrane kidneys, blood pressure control is an important measure to mitigate kidney damage and protect kidney function.
II. BP control target
General objective: For most patients with membrane kidneys, blood pressure control targets are usually below 130/80 mm mercury column (mmHg). This target is more stringent than the blood pressure control target (below 140/90 mmHg) for adults in general to reduce the risk of kidney damage.
Targets for individualisation: However, blood pressure control targets are not static, and individualisation targets should be based on the age, sex, availability of other complications (e.g. cardiovascular diseases, diabetes, etc.) and the extent of kidney damage. For example, more relaxed blood pressure control targets may be needed for elderly patients or patients with serious cardiovascular diseases.
III. Blood pressure control strategy
Lifestyle adjustments: First, patients should control blood pressure through lifestyle adjustments, including reduction of salt intake, maintenance of healthy weight, periodic exercise, restriction of alcohol intake, cessation of smoking, etc.
Drug treatment: If lifestyle adjustments are not sufficient to control blood pressure, pressure relief drugs are required. Commonly used decompressants include ACE inhibitors, ARBs, calcium route retardants, urea and beta receptor retardants. When choosing a drug, consideration should be given to its protective effect on the kidneys.
IV. Monitoring blood pressure
Family blood pressure monitoring: Meningocular kidney patients should regularly monitor blood pressure at home to understand how it is controlled. Household blood pressure monitoring helps to detect blood pressure fluctuations at an early stage and adjust treatment programmes in a timely manner.
Dynamic blood pressure monitoring: In some cases, 24-hour dynamic blood pressure monitoring may be required to more accurately assess blood pressure control.
V. Attention in blood pressure control
(b) Drug side effects: In the use of depressive drugs, patients should be aware of possible side effects, such as electrolyte imbalances, deterioration of kidneys, etc., and communicate with doctors in a timely manner.
Drug interaction: People with membrane kidneys may use multiple drugs at the same time, including immunosuppressants and urea, among others, requiring attention to the interaction between drugs.
Risk of low blood pressure: Control of blood pressure should not be too low in order to cause insufficient renal infusion and increase damage to kidney function.
Conclusions
The degree of control of blood pressure in patients with membrane kidneys is appropriate and needs to be determined on a case-by-case basis. In general, keeping blood pressure below 130/80 mmHg is a reasonable goal, but individual differences among patients should be taken into account. In the management of blood pressure, patients should work closely with kidney specialists and follow individualized treatment programmes to monitor blood pressure on a regular basis in order to achieve optimal treatment. Effective blood pressure control can slow the progress of membrane kidney disease, protect kidney function and reduce the risk of cardiovascular events.
