Kidney Stones

10:58 PM
5/20
http://www.symptomfind.com/health/preventing-kidney-stones/ http://www.medicinenet.com/polycystic_kidney_disease/page2.htm 10 Important Tips For Preventing Kidney Stones
By MaryAnn DePietroΙ March 13, 2012
AA
Kidney stones are hard, small masses, which can develop inside the kidneys. Risk factors include family history, dehydration, obesity, taking certain types of medications and eating a diet high in protein and salt. Stones can become very painful as they travel from the kidney and move into the ureter. In addition to pain, other symptoms include nausea, constant urge to urinate, red urine and fever. There are several things an individual can do to prevent kidney stones from developing.
1. Know What Type Of Stone You Have
There are a few different types of kidney stones including calcium, struvite and uric acid stones. If you have a history of stones, knowing which type you have developed can help you make the needed dietary changes to prevent future occurrences. For instance, if you are prone to uric acid stones, you may be instructed by your doctor to reduce protein intake. * Free Meal Planner
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Thousands Will Pray for You. www.ChristianPrayerCenter.com 2. Drink Plenty Of Water
One of the biggest risk factors for developing kidney stones is not drinking enough fluids. Drinking plenty of water helps dilute the urine, which helps if there is a buildup of uric acid or calcium. It also helps flush the excess salt from the urine and prevent stone formation. According to the Mayo Clinic, people who are prone to kidney stones should try to drink about two and half liters of water every day. More water may need to be consumed when exercising or spending time outside in hot weather.
3. Reduce Foods And Beverages Rich In Oxalates
Eating foods that are rich in oxalates may cause an increased risk in the formation of calcium oxalate kidney stones, according to the National Kidney Foundation. If you have a history of this type of kidney stone, foods high in oxalates, such as colas, chocolate, tea, peanuts and beets, should be limited for preventing kidney stones.
4. Ask Your Doctor Before Taking Calcium Supplements
It is important to understand eating foods high in calcium does not appear to be a risk factor for stone formation. According to the Mayo Clinic, calcium-rich foods should still be consumed unless otherwise instructed by your doctor, but taking calcium supplements may cause an increased risk of stone formation.
5. Eat Foods High In Phytate
Eating certain fiber rich foods, such as those containing phytates may help with preventing kidney stones. Phytate can help prevent calcium from crystallizing and prevent stones from forming. Foods such as rice bran, legumes and tree nuts are rich in phytates.
6. Learn Stress Reducing Techniques
According to the New York Times Health Guide, there appears to be a link between stress levels and the formation of kidney stones. Learning stress reduction techniques may not only help reduce the chances of stone formation, but can improve overall health. Participating in regular exercise, learning yoga and meditation are all examples of ways to reduce stress.
7. Limit Animal Protein Foods
Diets, which are high in protein, may cause excess uric acid to be excreted in the urine. When the urine becomes too acidic, a person may have an increased risk of kidney stones. The excess uric acid can crystallize, which causes the stone to form. Although protein is necessary in the diet, excess amounts should be avoided in people who are prone to uric acid kidney stones.
8. Watch Salt Intake
A diet high in salt results in more calcium being excreted in the urine, which can also cause kidney stones. People who are prone to calcium kidney stones should reduce salt intake to about 2400 mg, according to the National Institutes of Health. Foods which are generally high in salt and should be reduced include canned soup, luncheon meat and fast food.
9. Try Drinking A Half Cup Of Lemon Juice A Day
Pure lemon juice may not be your first choice when it comes to beverages, but drinking a half a cup a day may help prevent certain types of kidney stones. Lemon juice raises the amount of citrate in the urine, which decreases the chances of calcium stones from developing.
10. Consider Medication
In some cases, dietary changes may not be enough to stop kidney stones from forming, when this occurs, medication may be recommended. Certain medication may be prescribed which regulate the acidity of urine and help reduce stones from forming. Depending on which type of kidney stone you have a history of; medication may include antibiotics, a thiazide diuretic and medication to make the urine more alkaline.
According to the National Kidney Foundation, the incidence of kidney stones has been increasing in the last several decades and continues to rise. Kidney stones will affect about one in ten people during their lifetime. Having a kidney stone in the past is a risk factor for developing a stone in the future. Taking a proactive approach and implementing the preventive techniques listed above may help reduce the chances of kidney stones developing in the future.

3 Phases to Ayurvedic Kidney Cleansing (Stage 1,2 &3)
Kidney cleansing is important because it eliminates toxins and other wastes that may cause damage to the organs. There are various ways of cleansing the kidneys but one method that is slowly gaining popularity in the Western world is Ayurvedic cleansing. In observance of the National Kidney Awareness Month this March, we will take a look at this natural and holistic manner of flushing toxins from the body. Purva Karma
There are three phases to the Ayurvedic kidneys cleanse which is recommended at least once a year. The process takes about three weeks to complete. The cleanse starts with Purva Karma, the initial stage which prepares both the body and the mind. This initial phase requires modification of the diet three weeks before the cleansing. All stimulants like coffee and sweets, including dairy, are removed from the diet. A week before starting the cleansing process, the diet should largely comprise seeds and vegetables. A good stew recipe for this diet is Kitchari, made from rice, lentils or mung beans, onions and vegetables, ginger and garlic. To prepare the mind, meanwhile, means to take time off from daily regular activities in order to meditate. This may mean going for a stroll in the park or simply just having an “alone” time to practice deep inhaling that will clean the body of any opposing and destructive energy. Pancha Karma
The next phase is the Pancha Karma or the cleansing phase itself consisting of cleansing, enemas and laxatives. Enema kits and laxatives may be purchased from any local pharmacy. Through Pancha Karma the body eliminates Dosha (toxins). There are many subtypes of therapies and herbal massages under Pancha Karma that would include Basti (medicated enemas), Vamana (emesis through herbs), Virechana (purgation through herbs), Nasya (nasal administration of oils). These therapies eliminate deep-seated toxins from the body. Plain Kitchari Recipe
For the 3-day cleansing, you should only consume Kitchari and nothing else. Kitchari should be made fresh every day and can be re-reheated as much as needed to ensure that the meal is full of prana (energy). Wait for genuine hunger before going on the next meal. This means each meal should be taken between 3-4 hours. Though there are a variety of ways of making Kitchari, here is a recipe to follow for plain Kitchari. You will need ¼ cup basmati rice, ¼ cup mung beans, 1 cup water, 1 tablespoon yogurt or kefir, pinch of sea salt, 1 tablespoon butter or ghee. Mix rice, beans, water and yogurt in a pot and soak for 24 hours. In cooking, bring to a boil then turn heat to lowest setting for 35-40 minutes. Add salt and serve with butter or ghee. For variety you might add either cilantro or parsley to your Kitchari. During the cleansing phase massage your body every morning with oil appropriate for your skin type followed by hot shower. This helps in eliminating toxins from the body. Use a neti pot (for nasal irrigation) and tongue scraper daily. For your psyche, you can read, be creative, listen to quiet and soothing music or do some gardening. Avoid loud music and television. Take time to meditate, do some yoga or go on a nature walk. Enough rest is necessary if the cleansing process makes you tired. Rejuvenation
The last part is the Rejuvenation phase which lasts for about a week. This is where you slowly return to your regular Ayuverdic diet (rice, vegetables and spices like coriander, turmeric, ginger and cumin). Continue with regular meditation to ensure the rejuvenation of the psyche. Coming out of cleansing can be emotional that it is recommended that you should take time off from work for this last phase.

Category Archives: Bodily System Interactions

Potassium and Sodium, Another Key Electrolyte Pair

Sodium is everywhere!
Potassium and Sodium form another electrolyte pair that relate to each other and face connected problems when affected by kidney disease. First of all, these two chemicals form a specific balance of fluids inside and outside of the cells of the body. Potassium is highly concentrated inside cells, while sodium is more highly concentrated outside.
While sodium regulates fluid levels throughout the body itself, the sodium-potassium inside-outside chemical balance of the cells is very important. This balance creates an electrically charged potential at the cell membrane. And it’s this electrical potential that is crucial to such things as heart function, muscle contraction, and the transmission of nerve impulses. If these chemicals are thrown out of balance, it’s clear that people could suffer anything from heart problems to weak muscles or even nerve problems.
The kidneys serve a vital function in keeping these electrolytes balanced, excreting excess amounts so the body stays regulated. But what happens if there is more of a particular chemical in the body than the kidney can possibly eliminate? We see this question coming more and more to the forefront as the North American diet, in particular, is increasingly swamped with sodium. Excess sodium can lead to fluid retention, high blood pressure, and kidneys that become so overworked that they start to falter or even fail.
At the same time, if the kidneys aren’t able to function at full strength, and can no longer eliminate potassium in the way they are supposed to, people can begin to experience a condition known as hyperkalemia. This promotes further buildup of fluid in the body, but its worst effects have to do with the heart. It may result in a weak or irregular heartbeat, and a difficulty controlling the muscles. At its worst, it can lead to problems with breathing, weakness, or cardiac arrest. But like so many conditions related to kidney function, it often shows no symptoms at all until the kidneys are already severely compromised.
Doctors need to be careful in trying to rebalance sodium and potassium. When patients receive diuretics that promote urination, to remove excess sodium, they sometimes experience depleted potassium, which creates further nerve, heart, and muscle problems. Yet a lack of balance can damage the kidneys – and damaged kidneys can throw the balance even further out. It’s far better to eat a healthy diet and promote kidney health to begin with, than scramble to try to fix these electrolyte imbalances after they arise.

What Happens when Calcium and Phosphorus are Out of Balance
It’s been established that when a person has kidney disease, one of the big concerns becomes the balance of their electrolytes – that is, the electrically charged elements that move through the blood to help the body perform vital functions. Keeping the calcium and phosphorus balanced in the body becomes especially important, because these two electrolytes play a major role in building bones and teeth, and also in conveying energy throughout the body. So what happens if they do go out of balance? How does this imbalance manifest itself?

For kidney patients, white is better than whole grain
Diseased kidneys can’t get rid of excess phosphorus, nor can they activate Vitamin D, meaning calcium levels drop. The thyroid triggers more calcium both to bring those levels up and to balance the excess phosphorus. This extra calcium is often leeched from the bones, making them weaker. And calcium phosphate deposits, made from all this extra material, begin latching onto soft tissue, including in the arteries, heart, lungs, and joints. Eventually these deposits start to harden, creating health problems related to the lungs and heart. When this situation gets severe, it isn’t only the cardiovascular system that’s in danger. The leeching of calcium can make bones more bendable, and in the advanced stages of kidney failure, the jaw in particular becomes rubbery. Meanwhile, calcium phosphate deposits in other soft tissue creates inflammation that is hard to treat. And with the extra parathyroid levels, electrical impulses can’t travel properly along the nerves. This can lead to a patient being dazed and unresponsive.
Trying to maintain a low phosphorus diet can help somewhat, but it’s sometimes hard to avoid foods containing milk, whole grains, peas, etc. Doctors can also help by providing drugs that serve as phosphate binders. So it’s very important for people with even slight kidney problems to consult their physicians and keep checking their electrolyte levels.

Calcium, Phosphorus, and the Kidneys

Calcium & Phosphorus together help build the bones
Electrolytes float through the blood and perform various functions in people’s bodies. Calcium, Sodium, and Potassium, for example, work together to help the muscles of the body contract. And the work of some of these electrically charged substances is controlled or at least affected by the kidneys. This means that when the kidneys are diseased, the electrolytes may also function in an unhealthy way. Serious problems can arise that might, at first, seem unrelated to the kidneys at all. But to understand how these issues develop, we first need to know how electrolytes function when everything works properly.
Let’s take a look at two electrolytes – calcium and phosphorus – which often work together, each substance relying on the kidneys to keep it in balance with the other. The first function of the two is probably obvious: to help build up bones and teeth. Almost everyone knows that calcium is good for building bones, but few are aware that phosphorus is just as important. In fact, while about ninety-nine percent of the calcium in the body is concentrated in the bones, as much as eighty-five percent of the body’s phosphorus may also be found there.
In addition, phosphorus plays a major role in transferring energy throughout in the body. Calcium and phosphorus together help keep cells in good order, and regulate nerve function. Remember calcium’s role in helping muscles to contract? This would not be possible without phosphorus working right alongside it. The two electrolytes are equal partners.
The kidney helps keep phosphorus levels balanced by inducing the production of D vitamins, which in turn help the body excrete excess phosphorus. But as kidney disease progresses, the kidney becomes unable to trigger the Vitamin D. And that’s when the happy partnership of calcium and phosphorus becomes a nightmare instead. We’ll examine what happens under these circumstances with our next look at kidneys and the electrolytes.

Introduction to Electrolytes: Part 1

Electrolytes passing through cells (click to enlarge)
One topic that frequently comes up in connection with kidney disease is electrolytes. They play an important role in the body, and relate particularly to kidney malfunction. But what are they, and what do they actually do? We will explore this topic in several installments, to try to explain how electrolytes work, and why their levels are important to monitor when you have impaired kidneys. Electrolytes are substances that are electrically charged, or ionized. Because of this charge, they can carry electrical impulses along the nerves and muscles. These substances are, in fact, what make most parts of the body function at all. And if they aren’t present in proper levels, or certain types are out of balance, the body begins to suffer the consequences.
So for example, you may have some electrolytes carried along in the blood, and they would pass through membranes and cell walls into muscle tissue, to transmit impulses that make the tissue contract. Muscle contraction depends on the presence of three electrolytes in particular: Calcium (Ca2+), Sodium (Na+), and Potassium (K+), with the plus or minus values indicating what sorts of ions they are. Lower the levels of these three too much, or put them out of balance, and muscle function suffers.
So how does this relate to kidney disease? The kidneys play a major role in regulating fluids (which contain electrolytes) in the body. So when the kidneys are impaired or fail, this often throws out the balance, or results in a surfeit of some electrolytes. If this problem isn’t addressed, other parts of the body can be affected in serious ways, some of them potentially fatal.
In the next few installments, we’ll discuss specific types of electrolyte problems that are most closely associated with kidney disease. We’ll look at symptoms, but we’ll also try to discover ways to restore electrolyte levels and return to a safer, more healthy balance.

Mammograms and Kidney Disease Detection
A familiar method that doctors use to check for possible breast cancer turns out to be another way of checking the effects of kidney disease as well. Researchers have studied women receiving mammograms, and discovered that some of these effects manifest themselves in breast arteries. They show up in other arteries as well, but unless other parts of the body are similarly scanned, they won’t be noticed.
What some mammograms show is deposits of calcium left in the arteries. This calcification is a typical result of kidney disease, and if it increases, it can lead to cardiovascular disease as well. The progress of the calcium deposits can be studied over the months and years, as doctors assess the possible risks to the heart and lungs.
A happy coincidence — if you can properly call it that — is that women reach the age of needing mammograms at about the same time they would be manifesting kidney disease if they’re going to get it. Many of those who show calcification in the arteries will probably already know they have kidney problems. Yet in some cases, what shows on the mammogram may be their first hint.
Mammograms may not be the best diagnostic tools when it comes to kidney disease itself. There are many other more reliable tests for that. But these procedures can certainly help to keep track of some of the effects of the disease.
And more than that, having a fairly early indication of the calcification in the arteries can serve as a warning of a growing risk of cardiovascular disease. With this extra tool, doctors can be alerted and perhaps take steps to try to prevent things from going that far. In yet another example of the interconnectedness of the body’s systems, using a tool designed to detect one ailment may help in detecting or even preventing others.

Proven Method Of Cancer Detection Found Effective In Kidney Disease
Routine mammograms can show arterial calcium deposits—which may contribute to heart disease risk
Routine mammograms performed for breast cancer screening could serve another purpose as well: detecting calcifications in the blood vessels of patients with advanced kidney disease, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).
Mammograms show calcium deposits in the breast arteries in nearly two-thirds of women with end-stage renal disease (ESRD), according to the study by W. Charles O’Neill, MD (Emory University, Atlanta). “Breast arterial calcification is a specific and useful marker of medial vascular calcification in chronic kidney disease (CKD), and its prevalence is markedly increased in ESRD and advanced CKD,” the researchers write.
Arterial calcium deposits may contribute to the high rate of death from heart disease in patients with CKD and ESRD. In addition to calcifications of the inner or “intimal” layer of the blood vessels (atherosclerosis), calcifications can also occur in the middle, or “medial” layer. These medial calcium deposits may contribute to cardiovascular disease risk by making the arteries stiffer, but they can be difficult to detect.
In an initial study, Dr. O’Neill and colleagues examined samples of breast artery tissue from 16 women with kidney disease. While all of the samples showed medial calcifications of the breast artery, none showed intimal calcifications.
When the researchers reviewed routine mammograms performed in 71 women with ESRD, they found breast arterial calcifications in 63 percent of patients. In contrast, in a matched group of women without kidney disease, mammograms showed breast arterial calcifications in just 17 percent of cases.
Thirty-six percent of the women with kidney disease already had breast arterial calcifications on mammograms performed several years earlier—before their kidney disease advanced to ESRD. More than 90 percent of women with calcifications of the breast artery also had evidence of medical calcifications in other blood vessels.
Calcium deposits seen on mammograms could be “a marker of generalized medical vascular calcifications” in patients with kidney disease, the researchers write. The results support the theory that CKD predisposes to medial calcification, which may in turn, contribute to cardiovascular disease.
Since most women with CKD are at an age where yearly mammograms are recommended, mammograms may be a useful tool for studying the development and progression of medical calcifications. O’Neill and colleagues call for further studies of arterial calcium deposits in patients with kidney disease—including whether early identification and treatment might help to lower the associated risk of cardiovascular disease.
The study had some important limitations, including the relatively small number of patients studied.
Contact:
Shari Leventhal sleventhal@asn-online.org 202-416-0658
American Society of Nephrology

Retina Problems and Chronic Kidney Disease
In another instance demonstrating the interconnectivity of people’s bodily systems, a study about eye problems has led to an observation about kidney disease. The Beaver Dam Eye Study, according to their own description, was designed to “collect information on the prevalence and incidence of age-related cataract, macular degeneration and diabetic retinopathy.” But along the way, they also drew some conclusions about how disease of the kidneys, along with high blood pressure, can also affect the eyes.
Retinopathy, or the disease of the retina causing possible loss of vision, has always been associated with diabetes. But the researchers with the study learned that even those without diabetes can be at higher risk of retinopathy, if they have certain other health conditions. One was uncontrolled hypertension (high blood pressure), and the other was chronic kidney disease.
In 4,699 people between ages 43 and 86 (remember that this was an age-related study), the risk of experiencing retinopathy over a 15-year period was 14.2%. And in those study subjects who had either uncontrolled hypertension or chronic kidney disease, the risk of such negative effects on the eyes increased. That applied to subjects who were not diabetic, so the extra risk cannot be blamed on diabetes. In fact, several other things that one might have considered a real risk did not seem to factor in at all. These would include such things as smoking, body mass index (which would rule out obesity), or inflammation.
These interconnections shouldn’t be a surprise. Hypertension and kidney disease often do interact, and diabetes frequently involves extra complications such as high blood pressure and strain on the kidneys. People don’t always experience all three at the same time, but they are clearly related to each other. So it’s probably not a surprise that retinopathy – which is a very high risk for diabetics – can also factor into hypertension and kidney disease as well.
(Sources: Ocular Surgery News Supersite, December 23, 2010; The Beaver Dam Eye Study.)

Lupus and Kidney Disease may be a Deadly Combination
Kidney disease is related to a great many other diseases and conditions, the most common being high blood pressure and heart and stroke problems. But another condition it’s often linked with is lupus. And for those who have both lupus and kidney disease, the prognosis is unfortunately not good.
Systemic lupus erathymatosus, usually just called lupus, causes damage to the skin, joints, brain, and also to the kidneys. In fact, according to an article on the HealthDay website (Kidney Disease Could Be More Deadly for Kids With Lupus, Friday December 17, 2010), about eighty percent of children with lupus also suffer kidney damage. But whether it’s adults or children who have end-stage kidney disease caused by lupus, all have a higher likelihood of death from any cause than those who have the same kidney problems stemming from a different source.
Researchers from both Johns Hopkins University and the Children’s Hospital of Philadelphia studied the cases of 98,000 children, and this conclusion is what the evidence suggested. Children were 2.4 times more likely to die, when suffering from kidney disease caused by lupus, than children whose disease was caused by something else. Adults had a slightly better record, yet they were still almost twice as many times more likely to die.
While many causes seemed to lead to death for people with kidney disease caused by lupus, the most common cause, according to the study, seemed to be cardiovascular disease and cardiac arrest. For this reason, the researchers suggest that patients with the lupus-kidney combination probably need extra monitoring for atherosclerosis, or the thickening of the walls of the arteries. And when kidney patients are also diagnosed with lupus, that should send up a red flag of warning, so doctors can be more alert to the increased risks of death.
The study, entitled Increased risk of death in pediatric and adult patients with ESRD secondary to lupus, is published in the January 2011 issue of the journal, Pediatric Nephrology.

Lowering Salt Will Always Help Your Kidneys

Fresh, unsalted natural tastes
The idea seems straightforward when you think of high blood pressure: if you lower your salt intake, you will help to lower the blood pressure, or at least prevent it from getting worse. But the systems in our bodies don’t operate in isolation, and the good you do for one of them is bound to have positive effects in others. This was demonstrated yet again by a review conducted by the Cochrane Collaboration Renal Group.
This group reviewed thirteen studies relating to salt intake in diabetic patients. What they found was not entirely surprising, but the implications of their conclusions are widespread. First of all, they confirmed once again the connection of high salt intake and blood pressure issues. So clearly, diabetics would do well to reduce salt levels in their diet for that reason alone, because this reduction lowers the risk of strokes, heart attacks, and heart failure.
But the evidence gathered in the same studies also reinforces the understanding that high blood pressure is just as hard on the kidneys as on the heart. The studies also suggested that even for people whose blood pressure hasn’t yet inched into the “high” range, lowering salt intake will still have a positive effect on heart and kidney health.
This isn’t necessarily a rule condemning people to a life of tasteless food, however. Removing salt from one’s diet provides the opportunity to discover the natural, intrinsic tastes of food, and to combine these tastes into something that as delicious without needing a salty boost. While easing the blood pressure and helping the heart and kidneys, the lessening of salt might open up a whole new culinary world.
(View the Cochrane Renal Group Summary: Suckling RJ, He FJ, MacGregor GA. Altered dietary salt intake for preventing and treating diabetic kidney disease. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD006763. DOI: 10.1002/14651858.CD006763.pub2)
(Further reading: PulseToday, December 9, 2010; Nursing Times, December 10, 2010)

Category Archives: Detecting Kidney Disease

Children With Kidney Diseases Susceptible to High Blood Pressure
Do you know that high blood pressure is common in children with Chronic Kidney Disease (CKD)? It is common knowledge that high blood pressure (HBP) also known as hypertension is a precursor to most heart problems. Therefore it is important for children with CKD to have a regular blood pressure check up since early detection reduces the risks for complications.
In children, HBP is common among those who are overweight, African American, have CKD and have a family history of high blood pressure. When children are found to have HBP, parents should ensure that they get checked for kidney diseases as these may be an underlying cause. These include: inherited Polycystic Kidney Disease (PKD); Focal Segmental Glomerulosclerosis (FSGS) – referring to damage in the filtering units of the kidneys; and Hemolytic Uremic Syndrome (HUS), which affects the blood and blood vessels; and problems that block urine flow in the urinary tract.
Parents should remember to measure their child’s BP by using a blood pressure cuff that covers 80-100% of the circumference of child’s arm. There is also special equipment designed for infants and newborns. BP reading for children is similar to that of adults where there is the systolic BP (top number) and the diastolic BP (bottom number). As a person gets older and gains more weight his BP also increases. This means that a normal BP for children would be lower than the normal level for adults. A doctor’s pronouncement of HBP should be based on at least two blood pressure checkups. The normal level for children should be less than 130/80. Your child’s doctor can tell you the target BP for the child.
When your child has been diagnosed with both CKD and hypertension it is important that a doctor specializing in both diseases for children get involved in his/her care and treatment plan. The treatment may be a combination of lifestyle changes and taking blood pressure pills for children. The pills would include angiotensis converting enzyme inhibitor (ACE) or angiotensis receptor blocker (ARB). Studies have shown that these drugs also protect kidney function. Water pills may also be given to children who have water and salt retention. Most children with CKD need more than one medicine. Your child’s doctor will adjust the dosage base on his/her age and weight. As for lifestyle changes, an overweight child needs to lose weight, slow down snacking on salty foods like chips, and exercise regularly.
Your child’s BP should be checked every time you visit the doctor. Other important tests for the kidneys include: Glomerular Filtration Rate (to see if the kidneys are functioning properly); and urine protein level to determine if the CKD is getting worse. It also detects the development of heart and blood vessel diseases.

Detecting Kidney Disease – Stages One and Two

Checking the blood content levels to detect kidney disease
Chronic Kidney Disease appears in five stages, ranging from an early stage with little obvious effect to a final stage where the patient is on life-saving dialysis or awaiting a transplant. Each stage has certain characteristics and means of detection. The more that people know the various signs and effects of being in each stage, the sooner they may get a proper diagnosis from their doctor. Early detection is the best key to effective treatment.
Stage One leaves the patient with 90% kidney function. The person can survive at this level, but it’s still necessary to detect the problem so causes and treatments can be addressed. If they don’t take steps at this point, the disease is very likely to progress to the next level. Stage Two leaves only 60-89% kidney function, as the damage to these organs has increased.
The difficulty is that there are no obvious symptoms of kidney dysfunction at either stage. This may lead to a lack of detection at a crucial time when the disease could have been nipped in the bud, or curtailed before it got much worse. So it’s essential that the person have their regular yearly physical checkups, including urine tests and extensive blood work. Even with no other physical symptoms, these tests can detect: 1. elevated creatinine levels (which indicate how well the kidneys are filtering out wastes) 2. elevated protein levels (another indication of inefficiency in filtering wastes) 3. elevated blood urea nitrogen levels (kidneys take urea from the blood and expel it in the urine, but if the blood levels are high, this is another hint of failing kidneys)
In addition to the potential for early detection with blood and urine tests, high blood pressure is a well known hint of problems with kidney function. The most often mentioned symptom is high blood pressure, which can either cause kidney disease, or be caused by it. So if a person’s blood pressure rises, this can be a spur to doing the urine and blood tests, either to detect kidney disease or rule it out. And all steps (medication, exercise, alterations in diet) must be taken to bring the blood pressure down.
If blood and urine tests indicate a possible problem, doctors can go further and take a kidney biopsy, do a CT scan, or perform an MRI. So even at these early stages, while it’s more difficult, it’s still possible to detect incipient kidney disease. What it takes is vigilance, and thorough, regular checkups.

Detecting Kidney Disease – Stage Three

High blood pressure and kidney disease make each other worse
We’ve discussed Stages One and Two of kidney disease, and what to look for, to get one’s condition diagnosed as quickly as possible. But as many people learn to their distress, the first two stages of this disease are not easily detected unless one looks and watches very carefully. The first clearly noticeable symptoms finally reveal themselves as the disease reaches Stage Three, when already the person has less than 60% kidney function remaining, and may have as little as 30%. Yet even then, the symptoms can often be mistaken for something else. People can go on for a long time with such reduced kidney function, because some of the initial symptoms — tiredness and changes of appetite — are so vague that they could be caused by many other things. But when they are combined with other symptoms like itching, water retention, and anemia, this is when the pieces slowly fall into place. As the kidneys become less able to filter fluids and remove them from the body, more fluids are retained, and the person may experience swelling and puffiness. Even their urine may become more clear, because fewer impurities are being excreted.
Naturally this contributes to higher blood pressure. But the blood itself becomes more anemic, because it’s when the kidney releases the hormone erythropoietin (EPO) that red blood cells can be created. When the kidney can’t release as much EPO as it’s supposed to, the blood cell count goes lower and the patient becomes more anemic. In turn, the blood carries less oxygen and the body has to work harder in order to function. As a result, the person experiences greater and greater fatigue.
At this stage, the patient absolutely must take steps to reduce sodium in the diet and bring the blood pressure down. The higher the pressure, the more damage to vein walls, and the more damage to veins in the kidneys, the worse kidney function becomes. Adjustments must also be made to other elements of diet: protein will need to be reduced, though the patient can’t live completely without it. Patients may also need to take a phosphorus binder and vitamins that help boost kidney function. Working on these things with a knowledgeable dietitian is essential.
Even if earlier stages have been missed and the person has advanced well into Stage Three, it’s vital to get diagnosed as early as possible, to preserve what kidney function is left and prevent the disease from progressing any further.

Detecting Kidney Disease – Stage Four

Breaking bones may be a surprising result of Stage Four kidney disease
In previous entries, we’ve examined symptoms and effects of Stages One and Two of kidney disease, and then Stage Three, where things finally become noticeable and serious. In Stage Four of kidney disease, the symptoms start to be debilitating, and kidney function is severely impaired. In fact, at this stage, there is only 15-29% kidney function. The body may have disguised its condition for quite a while, but now the disease becomes drastically apparent.
The symptoms magnify things that had begun appearing in Stage Three: fatigue increases considerably, the appetite keeps declining, and an earlier phenomenon of itching might become much worse. High blood pressure continues to be problematic, because of course the kidneys have lost much of their capacity to excrete unneeded fluid, so it is retained in the body, making the heart and blood vessels work harder. And the kidneys may have trouble producing erythopoietin, which stimulates blood cell production, so anemia is another problem.
At Stage Four, a cascade of effects may produce other effects, all of which contribute to an increasing weakness and a worsening of symptoms. As the kidneys become less able to filter phosphate, the levels of that electrolyte increase. In turn, this makes it more difficult for the body to absorb calcium. And since it’s the proper interaction of phosphorous and calcium that strengthens bones, bone density itself may gradually decrease. This may produce aching in the bones, but it also leaves the person more prone to fractures, which take longer than usual to heal.
Treatments at this stage are many. Blood pressure is often treated with diuretics, though some of these can play havoc with potassium levels. Anemia can usually be successfully counteracted with drugs resembling erythopoietin. Medications may prevent bone disease, and much of the phosphorous/calcium imbalance can be reduced with diet.
But these are generally stop-gap measures. This is the stage where the patient begins heading in the direction of dialysis, and starts receiving consideration for a possible transplant. While the effects of Stage Four can be mitigated to some extent, the fact remains that the kidneys are so seriously diseased that the body can’t go on forever like this.
Again, it is extremely important to take good, thorough stock of one’s complete health every few months. The symptoms of kidney disease are easy to miss, in the stages when a person might do something about it.
Detecting Kidney Disease – Stage Five

Get those tests done -- early!
Why is it so important to detect kidney disease in its early stages, even if it’s rather hard to diagnose? Because when you reach Stage 4, you are likely past the point of living without serious medical intervention or even a transplant. And by the time you arrive at Stage 5, you have virtually no other option. There is nothing else to do but plan for a transplant.
In Stage 5, the kidneys have only about 15% of function left – or less. At this point, if left on their own, they would be completely unable to keep the patient alive. Dialysis now becomes very important to filter the blood of impurities the kidneys can’t remove.
Most symptoms are the same as for Stage 4 or earlier, but multiplied considerably. The person experiences the same tendency to hypertension (high blood pressure) because of the inability to expel fluids. And because the heart is working that much harder as a result, the person may suffer pericarditis, which is an inflammation of the lining around that organ. There would now be very high levels of creatinine and urea, which the kidneys can’t filter out. And susceptibility to infections would also increase.
The inability to absorb calcium or for the kidneys to produce the chemical that stimulates production of red blood cells worsens. And therefore the reduction in bone density and the tendency toward anemia would continue to be a problem. Added to these symptoms would come others that might seem comparatively “minor,” but which could be aggravating. These include difficulty sleeping, shortness of breath, increased itching, or frequent vomiting.
Certain treatments can attempt to bring down blood pressure or reduce anemia, while dietary adjustments may allow more absorption of calcium. But now with such reduced filtering capacity, dialysis is usually the only way to cleanse the bloodstream of impurities. Some patients can survive for a long time with dialysis treatments, though the most common form of dialysis takes several hours, three days a week, and therefore restricts their lifestyle. But for others, dialysis may lose its effectiveness relatively quickly. And the best hope in both cases is for a kidney transplant.
There are usually signs of kidney disease well before things reach Stage 5. To maintain good health and never allow themselves to arrive at this stage, the wisest course for everyone is to have yearly, thorough checkups with detailed blood work, and to investigate even the most nebulous symptoms that might indicate kidney disease.

Mammograms and Kidney Disease Detection
A familiar method that doctors use to check for possible breast cancer turns out to be another way of checking the effects of kidney disease as well. Researchers have studied women receiving mammograms, and discovered that some of these effects manifest themselves in breast arteries. They show up in other arteries as well, but unless other parts of the body are similarly scanned, they won’t be noticed.
What some mammograms show is deposits of calcium left in the arteries. This calcification is a typical result of kidney disease, and if it increases, it can lead to cardiovascular disease as well. The progress of the calcium deposits can be studied over the months and years, as doctors assess the possible risks to the heart and lungs.
A happy coincidence — if you can properly call it that — is that women reach the age of needing mammograms at about the same time they would be manifesting kidney disease if they’re going to get it. Many of those who show calcification in the arteries will probably already know they have kidney problems. Yet in some cases, what shows on the mammogram may be their first hint.
Mammograms may not be the best diagnostic tools when it comes to kidney disease itself. There are many other more reliable tests for that. But these procedures can certainly help to keep track of some of the effects of the disease.
And more than that, having a fairly early indication of the calcification in the arteries can serve as a warning of a growing risk of cardiovascular disease. With this extra tool, doctors can be alerted and perhaps take steps to try to prevent things from going that far. In yet another example of the interconnectedness of the body’s systems, using a tool designed to detect one ailment may help in detecting or even preventing others.
(For more information, read Proven Method of Cancer Detection Found Effective in Kidney Disease, January 25, 2010)

Polycystic: Not Your Garden Variety Kidney Disease
Most of the kidney disease people experience is caused by factors such as high blood pressure or as a complication of conditions like diabetes. But Polycystic Kidney Disease (or PKD) is a type of kidney disease that is of a completely different order. This is a condition that results from a person’s own genetic makeup.
The disorder, as its name suggests, causes multiple cysts to form mainly in the kidneys, although they can appear in other parts of the body too. These cysts are filled with fluid, and often enlarge the kidneys, sometimes until they weigh several pounds. The cysts take up space normally available for filtering purposes, which can ultimately lead to kidney failure. They also create higher blood pressure, which can go on to do other damage to the kidneys as well.
Symptoms of PKD, apart from high blood pressure, can include back pain, blood in the urine, an increase in abdomen size, and kidney stones. Cysts may also be found in other parts of the body such as the liver or pancreas, and they may even cause aneurysms in the brain.
Diagnosis is often not made until this condition has progressed quite far, but if a family member is known to have PKD, a person’s own chances of having it are increased. Blood and urine tests often don’t detect the problem early either, but ultrasound imaging, at least, can detect cysts greater than a half inch in size. Genetic tests can discern whether a person has the gene for PKD.
There is no prevention or cure available for PKD, but detection of the gene does give a person a chance to take some control. Regulating diet and blood pressure can help, and there are treatments for results of PKD such as pain, kidney stones, and headaches. As with all other forms of kidney disease, a healthy diet and blood pressure control are some of the most helpful steps to take.
(Further reading: Mayo Clinic – Polycystic Kidney Disease; MedicineNet.com – What is Polycystic Kidney Disease?)

Polycystic kidney disease * Basics * In-Depth * Multimedia * Expert Answers * Resources * Definition * Symptoms * Causes * Complications * Preparing for your appointment * Tests and diagnosis * Treatments and drugs * Coping and support * Prevention

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Definition
By Mayo Clinic staff | Normal and polycystic kidneys |
Polycystic kidney disease (PKD) is a disorder in which clusters of cysts develop primarily within your kidneys. Cysts are noncancerous round sacs containing water-like fluid.
Polycystic kidney disease isn't limited to your kidneys, although the kidneys usually are the most severely affected organs. The disease can cause cysts to develop in your liver and elsewhere in your body.
A common complication of polycystic kidney disease is high blood pressure. Kidney failure is another common problem for people with polycystic kidney disease.
Polycystic kidney disease varies greatly in its severity, and some complications are preventable. Lifestyle changes and medical treatments may help reduce damage to your kidneys from complications, such as high blood pressure.
Symptoms
By Mayo Clinic staff | Normal and polycystic kidneys |
Polycystic kidney disease symptoms may include: * High blood pressure * Back or side pain * Headache * Increase in the size of your abdomen * Blood in your urine * Frequent urination * Kidney stones * Kidney failure * Urinary tract or kidney infections
When to see a doctor
It's not uncommon for people to have polycystic kidney disease for years without developing signs or symptoms and without knowing they have the disease.
If you have some of the signs and symptoms of polycystic kidney disease, which include high blood pressure, an increase in the size of your abdomen, blood in your urine, back or side pain, or kidney stones, see your doctor to determine what might be causing them. If you have a first-degree relative — parent, sibling or child — with polycystic kidney disease, see your doctor to discuss the pros and cons of screening for this disorder. * Definition * Symptoms * Causes * Complications * Preparing for your appointment * Tests and diagnosis * Treatments and drugs * Coping and support * Prevention

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Causes
By Mayo Clinic staff | Autosomal dominant inheritance pattern | | Autosomal recessive inheritance pattern |
Cysts are noncancerous (benign) sacs that contain water-like fluid. They vary in size and as they accumulate more fluid can grow extremely large. Normally, a kidney weighs less than one-third of a pound (approximately three-quarters of a kilogram), while a kidney containing numerous cysts can weigh as much as 20 to 30 pounds (9.1 to 13.6 kilograms).
Abnormal genes cause polycystic kidney disease, and the genetic defects mean the disease runs in families. Rarely, a genetic mutation can be the cause of polycystic kidney disease. There are two types of polycystic kidney disease, caused by different genetic flaws: * Autosomal dominant polycystic kidney disease (ADPKD). Signs and symptoms of ADPKD often develop between the ages of 30 and 40. In the past, this type was called adult polycystic kidney disease, but children can develop the disorder. Only one parent needs to have the disease in order for it to pass along to the children. If one parent has ADPKD, each child has a 50 percent chance of getting the disease. This form accounts for about 90 percent of cases of polycystic kidney disease. * Autosomal recessive polycystic kidney disease (ARPKD). This type is far less common than is ADPKD. The signs and symptoms often appear shortly after birth. Sometimes, symptoms don't appear until later in childhood or during adolescence. Both parents must have abnormal genes to pass on this form of the disease. If both parents carry a gene for this disorder, each child has a 25 percent chance of getting the disease.
Researchers have identified two genes associated with ADPKD and one associated with ARPKD.
In some cases, a person with ADPKD has no known family history of the disease. However, it's possible that someone in the affected person's family actually did have the disease, but didn't show signs or symptoms before dying of other causes. In a smaller percentage of cases where no family history is present, ADPKD results from a spontaneous gene mutation.

Complications
By Mayo Clinic staff
There are numerous complications associated with polycystic kidney disease including: * High blood pressure. Elevated blood pressure is a common complication of polycystic kidney disease. Untreated, high blood pressure can cause further damage to your kidneys and increase your risk of heart disease and stroke. * Loss of kidney function. Progressive loss of kidney function is one of the most serious complications of polycystic kidney disease. Nearly half of those with the disease have kidney failure by age 60. If you have high blood pressure or blood or protein in your urine, you have a greater risk of kidney failure.
Polycystic kidney disease causes your kidneys to gradually lose their ability to eliminate wastes from your blood and maintain your body's balance of fluids and chemicals. As the cysts enlarge, they produce pressure and promote scarring in the normal, unaffected areas of your kidneys. These effects result in high blood pressure and interfere with the ability of your kidneys to keep wastes from building to toxic levels, a condition called uremia. As the disease worsens, end-stage kidney (renal) failure may result. When end-stage renal failure occurs, you'll need ongoing kidney dialysis or a transplant to prolong your life. * Pregnancy complications. Pregnancy is successful for most women with polycystic kidney disease. In some cases, however, women may develop a life-threatening disorder called preeclampsia. Those most at risk are women who have high blood pressure before they become pregnant. * Growth of cysts in the liver. The likelihood of developing liver cysts for someone with polycystic kidney disease increases with age. While both men and women develop cysts, women often develop larger cysts. Cyst growth may be aided by female hormones. * Development of an aneurysm in the brain. Localized enlargement of an artery in your brain can cause bleeding (hemorrhage) if it ruptures. People with polycystic kidney disease have a higher risk of aneurysm, especially those younger than age 50. The risk is higher if you have a family history of aneurysm or if you have uncontrolled high blood pressure. * Heart valve abnormalities. As many as one-quarter of adults with polycystic kidney disease develop mitral valve prolapse. When this happens, the valve no longer closes properly, which allows blood to leak backward. * Colon problems. Weaknesses and pouches or sacs in the wall of the colon (diverticulosis) may develop in people with polycystic kidney disease. * Chronic pain. Pain is a common symptom for people with polycystic kidney disease. It often occurs in your side or back. The pain can also be associated with a urinary tract infection or a kidney stone.
Preparing for your appointment * Definition * Symptoms * Causes * Complications * Preparing for your appointment * Tests and diagnosis * Treatments and drugs * Coping and support * Prevention

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Preparing for your appointment
By Mayo Clinic staff
If you have signs and symptoms of polycystic kidney disease, you're likely to start by seeing your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes in kidney health (nephrologist).
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do * Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. * Make a list of all medications, vitamins and supplements that you're taking. * Ask a family member or friend to come along. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot. * Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. For polycystic kidney disease, some basic questions to ask include: * What's the most likely cause of my symptoms? * Are there other possible causes for my symptoms? * What kinds of tests do I need? Do these tests require any special preparation? * Is this condition temporary or long lasting? * What treatments are available, and which do you recommend? * What types of side effects can I expect from treatment? * I have other health conditions. How can I best manage them together? * Do I need to follow any dietary restrictions? What about activity restrictions? * Is there a generic alternative to the medicine you're prescribing me? * What's the appropriate level for my blood pressure? What can I do to help bring it down? * Besides kidney cysts, what other complications might I have? * Are there any brochures or other printed material that I can take with me? What websites do you recommend?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions that come up during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your doctor may ask: * When did you first begin experiencing symptoms? * Have your symptoms been continuous or occasional? * Does anything seem to improve or worsen your symptoms? * Does anyone in your family have a history of polycystic kidney disease or other kidney disease? * Do you know your average blood pressure values? * Has your kidney function been measured? Tests and diagnosis
By Mayo Clinic staff
Several diagnostic methods are available to detect the size and number of kidney cysts as well as to evaluate the amount of healthy kidney tissue. * Ultrasound examination. In this common diagnostic method, a wand-like device called a transducer is placed on your body. It emits inaudible sound waves that are reflected back to the transducer — like sonar. A computer translates the reflected sound waves into images of your kidneys. * Computerized tomography (CT) scan. As you lie on a movable table, you're guided into a big doughnut-shaped device that projects very thin X-ray beams through your body. Your doctor is able to see cross-sectional images of your kidneys. * Magnetic resonance imaging (MRI) scan. As you lie inside a large cylinder, magnetic fields and radio waves generate cross-sectional views of your kidneys. Treatments and drugs
By Mayo Clinic staff
Treating polycystic kidney disease involves dealing with the following signs, symptoms and complications: * High blood pressure. Controlling high blood pressure may delay the progression of the disease and slow further kidney damage. Combining a low-sodium, low-fat diet that's moderate in protein and calorie content with not smoking, increasing exercise and reducing stress may help control high blood pressure.
However, medications are usually needed to control high blood pressure. Medications called angiotensin-converting enzyme (ACE) inhibitors may be used to control high blood pressure in people with polycystic kidney disease, though more than one drug may be necessary for good blood pressure control. * Pain. Chronic pain, usually located in your back or your side, is a common symptom of polycystic kidney disease. Often, the pain is mild and you can control it with over-the-counter medications containing acetaminophen. For some people, however, the pain is more severe and constant. In rare cases, your doctor may recommend surgery to remove cysts if they're large enough to cause pressure and pain. * Complications of cysts. Rarely, when kidney cysts are causing severe pain or obstructing other organs or blood vessels, you may need to undergo surgery to drain the cysts. * Bladder or kidney infections. Prompt treatment of infections with antibiotics is necessary to prevent kidney damage. * Blood in the urine. You'll need to drink lots of fluids as soon as you notice blood in your urine, in order to dilute the urine. Dilution may help prevent obstructive clots from forming in your urinary tract. Bed rest also may help decrease the bleeding. * Kidney failure. If your kidneys lose their ability to remove wastes and extra fluids from your blood, you'll eventually need either dialysis or a kidney transplant. * Liver cysts. Nonsurgical management of liver cysts includes avoidance of hormone replacement therapy. Other options in rare cases include drainage of symptomatic cysts if they're not too numerous, partial removal of the liver or even liver transplantation. * Aneurysms. If you have polycystic kidney disease and a family history of ruptured brain (intracranial) aneurysms, your doctor may recommend regular screening for intracranial aneurysms. If an aneurysm is discovered, surgical clipping of the aneurysm to reduce the risk of bleeding may be an option, depending on its size. Nonsurgical treatment of small aneurysms may involve controlling high blood pressure and high blood cholesterol, as well as quitting smoking. Polycystic Kidney Disease
(PKD)

1. Take the Kidney Disease Quiz 2. Kidney Stones Slideshow Pictures 3. High Blood Pressure Slideshow Pictures * What is Polycystic Kidney Disease? * What is autosomal dominant PKD? * What are the symptoms of autosomal dominant PKD? * How is autosomal dominant PKD diagnosed? * How is autosomal dominant PKD treated? * What is autosomal recessive PKD? * What are the symptoms of autosomal recessive PKD? * How is autosomal recessive PKD diagnosed? * How is autosomal recessive PKD treated? * What is a genetic disease? * Hope through research * Polycystic Kidney Disease At A Glance * Find a local Nephrologist in your town
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What is Polycystic Kidney Disease?
Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys. The kidneys are two organs, each about the size of a fist, located in the upper part of a person's abdomen, toward the back. The kidneys filter wastes and extra fluid from the blood to form urine. They also regulate amounts of certain vital substances in the body. When cysts form in the kidneys, they are filled with fluid. PKD cysts can profoundly enlarge the kidneys while replacing much of the normal structure, resulting in reduced kidney function and leading to kidney failure.
When PKD causes kidneys to fail-which usually happens after many years-the patient requires dialysis or kidney transplantation. About one-half of people with the most common type of PKD progress to kidney failure, also called end-stage renal disease (ESRD).
PKD can also cause cysts in the liver and problems in other organs, such as blood vessels in the brain and heart. The number of cysts as well as the complications they cause help doctors distinguish PKD from the usually harmless "simple" cysts that often form in the kidneys in later years of life.
In the United States, about 600,000 people have PKD, and cystic disease is the fourth leading cause of kidney failure. Two major inherited forms of PKD exist: * Autosomal dominant PKD is the most common inherited form. Symptoms usually develop between the ages of 30 and 40, but they can begin earlier, even in childhood. About 90 percent of all PKD cases are autosomal dominant PKD. * Autosomal recessive PKD is a rare inherited form. Symptoms of autosomal recessive PKD begin in the earliest months of life, even in the womb.
What is autosomal dominant PKD?
Autosomal dominant PKD is the most common inherited disorder of the kidneys. The phrase "autosomal dominant" means that if one parent has the disease, there is a 50 percent chance that the disease gene will pass to a child. In some cases-perhaps 10 percent-autosomal dominant PKD occurs spontaneously in patients. In these cases, neither of the parents carries a copy of the disease gene.
Many people with autosomal dominant PKD live for several decades without developing symptoms. For this reason, autosomal dominant PKD is often called "adult polycystic kidney disease." Yet, in some cases, cysts may form earlier in life and grow quickly, causing symptoms in childhood.

Picture of polycystic kidney, roughly retains the same shape as the healthy kidney.
The cysts grow out of nephrons, the tiny filtering units inside the kidneys. The cysts eventually separate from the nephrons and continue to enlarge. The kidneys enlarge along with the cysts-which can number in the thousands-while roughly retaining their kidney shape. In fully developed autosomal dominant PKD, a cyst-filled kidney can weigh as much as 20 to 30 pounds. High blood pressure is common and develops in most patients by age 20 or 30.
What are the symptoms of autosomal dominant PKD?
The most common symptoms are pain in the back and the sides (between the ribs and hips), and headaches. The dull pain can be temporary or persistent, mild or severe.
People with autosomal dominant PKD also can experience the following complications: * Urinary tract infections, specifically in the kidney cysts * Hematuria (blood in the urine) * Liver and pancreatic cysts * Abnormal heart valves * High blood pressure * Kidney stones; * Aneurysms (bulges in the walls of blood vessels) in the brain * Diverticulosis (small pouches bulge outward through the colon).
Blood in Urine
(Hematuria)

1. Take the UTI Quiz 2. Urinary Tract Infection (UTI) Slideshow Pictures 3. Urinary Incontinence in Women Slideshow Pictures
Medical Author:
Gary D. Steinberg, MD
Medical Author:
G. Joel DeCastro, MD
Medical Editor:
Melissa Conrad Stöppler, MD * What is blood in urine (hematuria)? * What are the causes of blood in urine? * How is blood in urine diagnosed? * How is blood in urine treated? * Blood in Urine (Hematuria) At A Glance * Patient Comments: Blood In Urine - Describe Your Experience * Patient Comments: Blood in Urine - Causes
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Kidney Stones: Symptoms, Causes, and Treatment
Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.
One in every 20 people develop a kidney stoneat some point in their life. Kidney stones, sometimes called renal calculi, form within the kidney itself or in other parts of the urinary tract.
People who have kidney stones report the sudden onset of excruciating cramping pain in their side, groin, or abdomen. Changes in body position do not relieve this pain. It may be so severe that it is accompanied by nausea and vomiting. Kidney stones also characteristically cause blood in the urine. If infection is present in the urinary tract along with the stones, there may be feverand chills.
Read more about kidney stones symptoms and diagnosis. »
What is blood in urine (hematuria)?
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Hematuria, or blood in the urine, can be either gross (visible) or microscopic (as defined by more than three to five red blood cells per high power field when viewed under magnification). Gross hematuria can vary widely in appearance, from light pink to deep red with clots. Despite the quantity of blood in the urine being different, the types of conditions that can cause the problem are the same, and the workup or evaluation that is needed is identical.
People with gross hematuria usually present to their doctor with this as a primary complaint. Microscopic hematuria, on the other hand, is most commonly detected as part of a periodic checkup by a primary-care physician.
What are the causes of blood in urine?
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The causes of gross and microscopic hematuria are similar and may result from bleeding anywhere along the urinary tract. One cannot readily distinguish between blood originating in the kidneys, ureters (the tubes that transport urine from the kidneys to the bladder), bladder, or urethra. Any degree of blood in the urine should be fully evaluated by a physician, even if it resolves spontaneously.
Infection of the urine, stemming either from the kidneys or bladder, is a common cause of microscopic hematuria. Kidney and bladder stones can cause irritation and abrasion of the urinary tract, leading to microscopic or gross hematuria. Trauma affecting any of the components of the urinary tract or the prostate can lead to bloody urine. Hematuria can also be associated with renal (or kidney) disease, as well as hematologic disorders involving the body's clotting system. Medications that increase the risk of bleeding, such as aspirin, warfarin (Coumadin), or clopidogrel (Plavix), may also lead to bloody urine. Lastly, cancer anywhere along the urinary tract can present with hematuria.

Next: How is blood in urine diagnosed?
Blood In Urine (cont.)

1. Take the UTI Quiz 2. Urinary Tract Infection (UTI) Slideshow Pictures 3. Urinary Incontinence in Women Slideshow Pictures
Medical Author:
Gary D. Steinberg, MD
Medical Author:
G. Joel DeCastro, MD
Medical Editor:
Melissa Conrad Stöppler, MD
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In this Article * What is blood in urine (hematuria)? * What are the causes of blood in urine? * How is blood in urine diagnosed? * How is blood in urine treated? * Blood in Urine (Hematuria) At A Glance * Patient Comments: Blood In Urine - Describe Your Experience * Patient Comments: Blood in Urine - Causes * Blood In Urine Index
How is blood in urine diagnosed?
The evaluation for blood in urine consists of taking a history, performing a physical examination, evaluating the urine under a microscope, and obtaining a culture of the urine. Lower urinary tract symptoms, such as urgency (feeling a strong need to urinate) and frequency (needing to urinate frequently), as well as the presence of fever and/or chills are suggestive of infection. Recent trauma, even if believed by the patient to have been inconsequential, should be considered as a potential cause. Abdominal and/or flank pain, especially if radiating to the inguinal or the genital area, may suggest kidney stones. All recent medications, including vitamins or herbal supplements, should be reviewed with the health-care provider. However, it is important to note that even if the patient has been taking a medication that is associated with bleeding, a full workup (as listed below) should still be undertaken.
The physical exam will focus on possible sources of hematuria. Bruising over the back or abdomen may indicate trauma. A digital rectal exam should be performed, as findings consistent with prostatitis (for example, tenderness on palpation of the prostate) or an enlarged prostate (suggestive of BPH or benign enlargement of the prostate gland) may be useful in making a diagnosis. A repeat urinalysis, as well as a urine culture, should be obtained. The presence of white blood cells on urinalysis is more consistent with a urinary tract infection. Protein, glucose, or sediment in the urine may indicate the presence of a disease of the kidneys. Blood tests are also important, as they will aid in assessing renal function and identifying any clotting abnormalities.
In addition to the basic history and physical exam, there are three additional components for any workup of hematuria: CT scan, urine cytology, and cystoscopy.
The CT scan is an imaging evaluation of the urinary tract. Prior to the procedure, the patient drinks an oral contrast agent and a dye is injected intravenously. The patient then goes through the CT scan machine and images are taken of the abdomen and pelvis. Another test that can be performed, the intravenous pyelogram (IVP), is also a type of X-ray evaluation of the urinary tract. In this procedure, a dye is injected into the veins, and this is filtered by the urinary tract. A series of X-rays are then taken over a 30-minute period to look for abnormalities. The CT scan is more commonly performed than the IVP to evaluate the urinary tract and should be considered the test of choice. Both of these studies are especially useful for evaluating the kidneys and ureters but not the bladder, prostate, or urethra. Therefore, a second examination called a cystoscopy is necessary. This is a simple 10-minute procedure wherein a thin, flexible cystoscope (or fiberoptic camera) is inserted via the urethra into the bladder in order to directly visualize any lesions or sources of bleeding. This is usually done with local anesthetic jelly injected into the urethra. Finally, urine cytology involves giving a urine sample to be analyzed by a pathologist for the presence of cancerous or abnormal-appearing cells.

Next: How is blood in urine treated?
Blood In Urine (cont.)

1. Take the UTI Quiz 2. Urinary Tract Infection (UTI) Slideshow Pictures 3. Urinary Incontinence in Women Slideshow Pictures
Medical Author:
Gary D. Steinberg, MD
Medical Author:
G. Joel DeCastro, MD
Medical Editor:
Melissa Conrad Stöppler, MD
Share this Article:
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In this Article * What is blood in urine (hematuria)? * What are the causes of blood in urine? * How is blood in urine diagnosed? * How is blood in urine treated? * Blood in Urine (Hematuria) At A Glance * Patient Comments: Blood In Urine - Describe Your Experience * Patient Comments: Blood in Urine - Causes * Blood In Urine Index
How is blood in urine treated?
Treatments for hematuria vary widely and depend wholly upon the reason for the bleeding. It is important to note that there is often no source found for the hematuria. This should not be a source of major concern, however, since an appropriate workup effectively rules out the most serious causes of hematuria (for example, cancer). In cases where a workup is negative and the cause of the hematuria remains unknown, observation with repeat urinalyses is a reasonable option. A blood test to check kidney function and a blood-pressure check should be done as well. Men over 50 should discuss with their doctor the yearly prostate-specific antigen (PSA) blood test to screen for prostate cancer.
Further discussion of the treatment for hematuria would depend upon the results of the previously mentioned workup and the exact cause for the hematuria. The urologist who performs this examination would direct any further treatment or workup that would be necessary.
Blood in Urine (Hematuria) At A Glance * Blood in urine can sometimes be visible only with a microscope. * Evaluating blood in urine requires consideration of the entire urinary tract. * Tests used for the diagnosis of blood in urine include a CT scan, cystoscopy, and urine cytology. * Management of blood in the urine depends upon the underlying cause.
Previous contributing author: Mark H. Katz, MD

Last Editorial Review: 11/6/2009

Next: Patient Comments: Blood In Urine - Describe Your Experience
Patient Comments: Blood In Urine - Describe Your Experience

1. Take the UTI Quiz 2. Urinary Tract Infection (UTI) Slideshow Pictures 3. Urinary Incontinence in Women Slideshow Pictures
Please describe your experience with blood in urine. * 1 * 2 * 3 * 4 * Next
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Published: May 09
If I don't drink water in a six-hour period, I get blood in my urine. When I drink lots of water, my urine gets transparent.
Published: July 07
I am 28 years old and have been drinking heavily for approx. 12 years. I wet the bed fairly often involuntarily after having drank heavily, and the other morning I woke to discover noticeable blood in my urine. What could cause this? I have no money, no job, and can't afford to have it checked out right now. Could it be effects of drinking for years, like a kidney or liver problem? Other than my drinking problem, I consider myself healthy, with very rare illness.
Published: July 01
Blood showed up in my urine suddenly this Saturday morning. There were no warnings and no symptoms. It has been there continually throughout the day, whenever I urinate. I'm on Coumadin, and I think I've been prescribed an excessive amount. I plan to have a ProTime test Monday and then talk to my cardiologist. The next step would be a visit to a urologist, but I have a strong hunch that blood thinning is the cause.
Published: June 25
I regularly have blood in my urine, although it is not seen with the naked eye. It is diagnosed when I have a physical, admitted to hospital for other things, etc. I have been to a urologist a few years ago, and they said nothing was wrong at that time, but it continues.
Published: June 25
I have a complete duplex system on one side of my kidneys. For the past 14 months I have had constant blood in my urine, sometimes it's visible to the naked eye and other times it is only visible microscopically. No infection is found.
Published: June 19
My son is only eight; he has had a significant amount of blood and protein in his urine for over five weeks. He has been through two ultrasounds, a CT scan, and lots of blood work. He has moderate lower abdominal pain that comes and goes and he has been complaining of vision problems. He has seen four doctors and is scheduled for two more. Still no diagnosis.
Published: June 18
I am a 51 year old male, after working outside all day, when I get home and go to bathroom my urine has a bright red tint to it.
Published: June 17
I have had burning and pain on urination for a week. Treated with ABX and Pyridium the symptoms persisted. Yesterday, I put a warm wash cloth on the area of relief and bright red blood was on the cloth.
Published: June 17 I had a very big discharge of blood and brown mush. In afternoon I felt shivery/funny/dizzy. At 18.00 I noticed slight burning when urinating, but the urine was clear and pale as normal. Pain got worse but at 23.30 bed time urine was still clear and normal. In bed I felt very uncomfortable between my legs and made several trips to bathroom to see if I needed to pass a stool but didn't. At 23.50 I urinated bright pink with blood clots. At 23.55 I urinated bright pink with a lot of brown mushy bits and blood clots. While waiting for ambulance and in A&E I urinated about 15 times with the same pink urine, diminishing amount of brown mush and blood clots. Doctor examined me and diagnoses urine infection and gave me Trimethoprim. Bye 06.00 urine was clear and faint brown. By 09.00 it was clear and pale yellow. At 10.00 it was back to normal clear. The whole episode took just about 15/16 hours but the quantity of blood and brown mush was terrifying.

Polycystic Kidney Disease (cont.)

1. Take the Kidney Disease Quiz 2. Kidney Stones Slideshow Pictures 3. High Blood Pressure Slideshow Pictures
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In this Article * What is Polycystic Kidney Disease? * What is autosomal dominant PKD? * What are the symptoms of autosomal dominant PKD? * How is autosomal dominant PKD diagnosed? * How is autosomal dominant PKD treated? * What is autosomal recessive PKD? * What are the symptoms of autosomal recessive PKD? * How is autosomal recessive PKD diagnosed? * How is autosomal recessive PKD treated? * What is a genetic disease? * Hope through research * Polycystic Kidney Disease At A Glance * Find a local Nephrologist in your town * Polycystic Kidney Disease Index
How is autosomal dominant PKD diagnosed?
Autosomal dominant PKD is usually diagnosed by kidney imaging studies. The most common form of diagnostic kidney imaging is ultrasound, but more precise studies, such as computerized tomography (CT) scans or magnetic resonance imaging (MRI) are also widely used. In autosomal dominant PKD, the onset of kidney damage and how quickly the disease progresses can vary. Kidney imaging findings can also vary considerably, depending on a patient's age. Younger patients usually have both fewer and smaller cysts. Doctors have therefore developed specific criteria for diagnosing the disease with kidney imaging findings, depending on patient age. For example, the presence of at least two cysts in each kidney by age 30 in a patient with a family history of the disease can confirm the diagnosis of autosomal dominant PKD. If there is any question about the diagnosis, a family history of autosomal dominant PKD and cysts found in other organs make the diagnosis more likely.
In most cases of autosomal dominant PKD, patients have no symptoms and their physical condition appears normal for many years, so the disease can go unnoticed. Physical checkups and blood and urine tests may not lead to early diagnosis. Because of the slow, undetected progression of cyst growth, some people live for many years without knowing they have autosomal dominant PKD.
Once cysts have grown to about one-half inch, however, diagnosis is possible with imaging technology. Ultrasound, which passes sound waves through the body to create a picture of the kidneys, is used most often. Ultrasound imaging does not use any injected dyes or radiation and is safe for all patients, including pregnant women. It can also detect cysts in the kidneys of a fetus, but large cyst growth this early in life is uncommon in autosomal dominant PKD.
More powerful and expensive imaging procedures such as CT scans and MRI also can detect cysts. Recently, MRI has been used to measure kidney and cyst volume and monitor kidney and cyst growth, which may serve as a way to track progression of the disease.
Diagnosis can also be made with a genetic test that detects mutations in the autosomal dominant PKD genes, called PKD1 and PKD2. Although this test can detect the presence of the autosomal dominant PKD mutations before large cysts develop, its usefulness is limited by two factors: detection of a disease gene cannot predict the onset of symptoms or ultimate severity of the disease, and if a disease gene is detected, no specific prevention or cure for the disease exists. However, a young person who knows of a PKD gene mutation may be able to forestall the loss of kidney function through diet and blood pressure control. The genetic test may also be used to determine whether a young member of a PKD family can safely donate a kidney to a family member with the disease. Individuals with a family history of PKD who are of childbearing age might also want to know whether they have the potential of passing a PKD gene to a child. Anyone considering genetic testing should receive counseling to understand all the implications of the test. Polycystic Kidney Disease (cont.)

1. Take the Kidney Disease Quiz 2. Kidney Stones Slideshow Pictures 3. High Blood Pressure Slideshow Pictures
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In this Article * What is Polycystic Kidney Disease? * What is autosomal dominant PKD? * What are the symptoms of autosomal dominant PKD? * How is autosomal dominant PKD diagnosed? * How is autosomal dominant PKD treated? * What is autosomal recessive PKD? * What are the symptoms of autosomal recessive PKD? * How is autosomal recessive PKD diagnosed? * How is autosomal recessive PKD treated? * What is a genetic disease? * Hope through research * Polycystic Kidney Disease At A Glance * Find a local Nephrologist in your town * Polycystic Kidney Disease Index
How is autosomal dominant PKD treated?
Although a cure for autosomal dominant PKD is not available, treatment can ease symptoms and prolong life.
Pain. Pain in the area of the kidneys can be caused by cyst infection, bleeding into cysts, kidney stone, or stretching of the fibrous tissue around the kidney with cyst growth. A doctor will first evaluate which of these causes are contributing to the pain to guide treatment. If it is determined to be chronic pain due to cyst expansion, the doctor may initially suggest over-the-counter pain medications, such as aspirin or acetaminophen (Tylenol). Consult your doctor before taking any over-the-counter medication because some may be harmful to the kidneys. For most but not all cases of severe pain due to cyst expansion, surgery to shrink cysts can relieve pain in the back and sides. However, surgery provides only temporary relief and does not slow the disease's progression toward kidney failure.
Headaches that are severe or that seem to feel different from other headaches might be caused by aneurysms-blood vessels that balloon out in spots-in the brain. These aneurysms could rupture, which can have severe consequences. Headaches also can be caused by high blood pressure. People with autosomal dominant PKD should see a doctor if they have severe or recurring headaches-even before considering over-the-counter pain medications.
Urinary tract infections. People with autosomal dominant PKD tend to have frequent urinary tract infections, which can be treated with antibiotics. People with the disease should seek treatment for urinary tract infections immediately because infection can spread from the urinary tract to the cysts in the kidneys. Cyst infections are difficult to treat because many antibiotics do not penetrate the cysts.
High blood pressure. Keeping blood pressure under control can slow the effects of autosomal dominant PKD. Lifestyle changes and various medications can lower high blood pressure. Patients should ask their doctors about such treatments. Sometimes proper diet and exercise are enough to keep blood pressure controlled.
End-stage renal disease. After many years, PKD can cause the kidneys to fail. Because kidneys are essential for life, people with ESRD must seek one of two options for replacing kidney functions: dialysis or transplantation. In hemodialysis, blood is circulated into an external filter, where it is cleaned before re-entering the body; in peritoneal dialysis, a fluid is introduced into the abdomen, where it absorbs wastes and is then removed. Transplantation of healthy kidneys into ESRD patients has become a common and successful procedure. Healthy-non-PKD-kidneys transplanted into PKD patients do not develop cysts.
Polycystic Kidney Disease (cont.)

1. Take the Kidney Disease Quiz 2. Kidney Stones Slideshow Pictures 3. High Blood Pressure Slideshow Pictures
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In this Article * What is Polycystic Kidney Disease? * What is autosomal dominant PKD? * What are the symptoms of autosomal dominant PKD? * How is autosomal dominant PKD diagnosed? * How is autosomal dominant PKD treated? * What is autosomal recessive PKD? * What are the symptoms of autosomal recessive PKD? * How is autosomal recessive PKD diagnosed? * How is autosomal recessive PKD treated? * What is a genetic disease? * Hope through research * Polycystic Kidney Disease At A Glance * Find a local Nephrologist in your town * Polycystic Kidney Disease Index
What is autosomal recessive PKD?
Autosomal recessive PKD is caused by a mutation in the autosomal recessive PKD gene, called PKHD1. Other genes for the disease might exist but have not yet been discovered by scientists. We all carry two copies of every gene. Parents who do not have PKD can have a child with the disease if both parents carry one copy of the abnormal gene and both pass that gene copy to their baby. The chance of the child having autosomal recessive PKD when both parents carry the abnormal gene is 25 percent. If only one parent carries the abnormal gene, the baby cannot get autosomal recessive PKD but could ultimately pass the abnormal gene to his or her children.
The signs of autosomal recessive PKD frequently begin before birth, so it is often called "infantile PKD." Children born with autosomal recessive PKD often, but not always, develop kidney failure before reaching adulthood. Severity of the disease varies. Babies with the worst cases die hours or days after birth due to respiratory difficulties or respiratory failure.
Some people with autosomal recessive PKD do not develop symptoms until later in childhood or even adulthood. Liver scarring occurs in all patients with autosomal recessive PKD and tends to become more of a medical concern with increasing age.
What are the symptoms of autosomal recessive PKD?
Children with autosomal recessive PKD experience high blood pressure, urinary tract infections, and frequent urination. The disease usually affects the liver and spleen, resulting in low blood cell counts, varicose veins, and hemorrhoids. Because kidney function is crucial for early physical development, children with autosomal recessive PKD and decreased kidney function are usually smaller than average size. Recent studies suggest that growth problems may be a primary feature of autosomal recessive PKD.

Next: How is autosomal recessive PKD diagnosed? Polycystic Kidney Disease (cont.)

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In this Article * What is Polycystic Kidney Disease? * What is autosomal dominant PKD? * What are the symptoms of autosomal dominant PKD? * How is autosomal dominant PKD diagnosed? * How is autosomal dominant PKD treated? * What is autosomal recessive PKD? * What are the symptoms of autosomal recessive PKD? * How is autosomal recessive PKD diagnosed? * How is autosomal recessive PKD treated? * What is a genetic disease? * Hope through research * Polycystic Kidney Disease At A Glance * Find a local Nephrologist in your town * Polycystic Kidney Disease Index
How is autosomal recessive PKD diagnosed?
Ultrasound imaging of the fetus or newborn reveals enlarged kidneys with an abnormal appearance, but large cysts such as those in autosomal dominant PKD are rarely seen. Because autosomal recessive PKD tends to scar the liver, ultrasound imaging of the liver also aids in diagnosis.
How is autosomal recessive PKD treated?
Medicines can control high blood pressure in autosomal recessive PKD, and antibiotics can control urinary tract infections. Eating increased amounts of nutritious food improves growth in children with autosomal recessive PKD. In some cases, growth hormones are used. In response to kidney failure, autosomal recessive PKD patients must receive dialysis or transplantation. If serious liver disease develops, some people can undergo combined liver and kidney transplantation.
What are genetic diseases?
Genes are segments of DNA, the long molecules that reside in each of a person's cells. The genes, through complex processes, build proteins for growth and maintenance of the body. At conception, DNA-or genes-from both parents are passed to the child.
A genetic disease occurs when one or both parents pass abnormal genes to a child at conception. If receiving an abnormal gene from just one parent is enough to produce a disease in the child, the disease is said to have dominant inheritance. If receiving abnormal genes from both parents is needed to produce disease in the child, the disease is said to be recessive. A genetic disease can also occur through a spontaneous mutation.
The chance of acquiring a dominant disease is higher than the chance of acquiring a recessive disease. A child who receives only one gene copy for a recessive disease at conception will not develop the genetic disease-such as autosomal recessive PKD-but could pass the gene to the following generation.

Next: Hope through research Polycystic Kidney Disease (cont.)

1. Take the Kidney Disease Quiz 2. Kidney Stones Slideshow Pictures 3. High Blood Pressure Slideshow Pictures
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In this Article * What is Polycystic Kidney Disease? * What is autosomal dominant PKD? * What are the symptoms of autosomal dominant PKD? * How is autosomal dominant PKD diagnosed? * How is autosomal dominant PKD treated? * What is autosomal recessive PKD? * What are the symptoms of autosomal recessive PKD? * How is autosomal recessive PKD diagnosed? * How is autosomal recessive PKD treated? * What is a genetic disease? * Hope through research * Polycystic Kidney Disease At A Glance * Find a local Nephrologist in your town * Polycystic Kidney Disease Index
Hope through research
Scientists have begun to identify the processes that trigger formation of PKD cysts. Advances in the field of genetics have increased our understanding of the abnormal genes responsible for autosomal dominant and autosomal recessive PKD. Scientists have located two genes associated with autosomal dominant PKD. The first was located in 1985 on chromosome 16 and labeled PKD1. PKD2 was localized to chromosome 4 in 1993. Within 3 years, scientists had isolated the proteins these two genes produce-polycystin-1 and polycystin-2.
When both the PKD1 and PKD2 genes are normal, the proteins they produce work together to foster normal kidney development and inhibit cyst formation. A mutation in either of the genes can lead to cyst formation, but evidence suggests that disease development also requires other factors, in addition to the mutation in one of the PKD genes.
Genetic analyses of most families with PKD confirm mutations in either the PKD1 or PKD2 gene. In about 10 to 15 percent of cases, however, families with autosomal dominant PKD do not show obvious abnormalities or mutations in the PKD1 and PKD2 genes, using current testing methods.
Researchers have also recently identified the autosomal recessive PKD gene, called PKHD1, on chromosome 6. Genetic testing for autosomal recessive PKD to detect mutations in PKHD1 is now offered by a limited number of molecular genetic diagnostics laboratories in the United States.
Researchers have bred rodents with a genetic disease that parallels both inherited forms of human PKD. Studying these mice will lead to greater understanding of the genetic and nongenetic mechanisms involved in cyst formation. In recent years, researchers have discovered several compounds that appear to inhibit cyst formation in mice with the PKD gene. Some of these compounds are in clinical testing in humans. Scientists hope further testing will lead to safe and effective treatments for humans with the disease.
Recent clinical studies of autosomal dominant PKD are exploring new imaging methods for tracking progression of cystic kidney disease. These methods, using MRI, are helping scientists design better clinical trials for new treatments of autosomal dominant PKD.
People interested in participating in clinical trials of new treatments for PKD can find a list of centers recruiting patients at www.ClinicalTrials.gov.

Next: Polycystic Kidney Disease At A Glance
Polycystic Kidney Disease (cont.)

1. Take the Kidney Disease Quiz 2. Kidney Stones Slideshow Pictures 3. High Blood Pressure Slideshow Pictures
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In this Article * What is Polycystic Kidney Disease? * What is autosomal dominant PKD? * What are the symptoms of autosomal dominant PKD? * How is autosomal dominant PKD diagnosed? * How is autosomal dominant PKD treated? * What is autosomal recessive PKD? * What are the symptoms of autosomal recessive PKD? * How is autosomal recessive PKD diagnosed? * How is autosomal recessive PKD treated? * What is a genetic disease? * Hope through research * Polycystic Kidney Disease At A Glance * Find a local Nephrologist in your town * Polycystic Kidney Disease Index
Polycystic Kidney Disease At A Glance * The two forms of polycystic kidney disease (PKD) are * autosomal dominant PKD, a form that usually causes symptoms in adulthood * autosomal recessive PKD, a rare form that usually causes symptoms in infancy and early childhood * The symptoms and signs of PKD include * pain in the back and lower sides * headaches * urinary tract infections * blood in the urine * cysts in the kidneys and other organs * Diagnosis of PKD is obtained by * ultrasound imaging of kidney cysts * ultrasound imaging of cysts in other organs * family medical history, including genetic testing * PKD has no cure. Treatments include * medicine to control high blood pressure * medicine and surgery to reduce pain * antibiotics to resolve infections * dialysis to replace functions of failed kidneys kidney transplantation
SOURCE: National Institutes of Health
References: Grantham JJ, Nair V, Winklhoffer F. Cystic diseases of the kidney. In: Brenner BM, ed. Brenner & Rector's The Kidney. Vol. 2. 6th ed. Philadelphia: WB Saunders Company; 2000: 1699-1730. Polycystic Kidney Disease Index

Featured: Polycystic Kidney Disease Main Article
Polycystic kidney disease (PKD) is characterized by numerous cysts in the kidneys. Polycystic kidney disease is a genetic disorder. There are two major inherited forms of PKD, autosomal dominant PKD, and autosomal recessive PKD. Symptoms include headaches, urinary tract infections, blood in the urine, liver and pancreatic cysts, abnormal heart valves, high blood pressure, kidney stones, aneurysms, and diverticulosis. Diagnosis of PKD is generally with ultrasound, CT or MRI scan. There is no cure for PKD, so treatment of symptoms is usually the general protocol.
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Kidney Disease Quiz: Test Your Medical IQ Kidney disease is common. Take this kidney disease quiz to test your knowledge and learn the symptoms, causes and types of kidney...learn more » *
Picture of Kidneys The kidneys are a pair of organs located in the back of the abdomen. See a picture of the Kidneys and learn more about the health...learn more »
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Kidney Failure Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss,...learn more »
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Urinary Tract Infection (UTI In Adults) Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not everyone with a UTI has...learn more »
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High Blood Pressure High blood pressure, also known as hypertension, is a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a...learn more »
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Headache Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches,...learn more »
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Cysts Cysts are saclike structures that can occur throughout the body and usually contain a semisolid, liquid, or gaseous substance....learn more »
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Kidney Infection (Pyelonephritis) Kidney infection (pyelonephritis) usually is caused from bacteria that have spread from the bladder from a UTI (urinary tract...learn more »
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Blood Clots

1. Heart Disease Slideshow Pictures 2. Medical Illustrations of the Heart Image Collection 3. Take the Heart Disease Quiz!
Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor:
Melissa Conrad Stöppler, MD * Blood clot facts * What are blood clots? * What causes blood clots? * What does a blood clot look like? * What are the risk factors for blood clots? * What types and conditions are caused by blood clots? * What are the symptoms of blood clots? * How are blood clots diagnosed? * What is the treatment for blood clots? * What are the complications of blood clots? * How can blood clots be prevented? * Patient Comments: Blood Clots - Describe Your Experience * Patient Comments: Blood Clots - Causes * Patient Comments: Blood Clots - Symptoms
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How Pie Prevents Blood Clots
Deep venous thrombosis, or DVT, is the medical term for a blood clot in that deeper system. The symptoms of pain, swelling, and redness are similar to those of infection, and sometimes it's hard to tell the two apart, except by using ultrasound to check the flow of blood in the veins. But the DVT is just the harbinger (sign) of potential disaster. If a clot has formed, it can grow and break off and float downstream. Downstream means through the heart and into the lungs, where it can get lodged and make the lungs fail. A clot that breaks free and moves is called an embolus, and a pulmonary (lung) embolus is a big deal and a killer.
Read the rest of how Pie prevents blood clots »
Blood clot facts * Blood clots form when blood fails to circulate adequately. * Arterial thrombi form when a plaque ruptures and promotes an acute clot formation. * Venous thrombosis occurs when prolonged immobilization allows blood to pool in an extremity and then clot. * The diagnosis is suggested by the history and physical examination and often confirmed with a radiologic test. * Treatment may require surgery, anti-coagulation medications, or a combination of the two. * Prevention of blood clots involves attention to the risk factors for vascular disease. * Serious complications can arise from blood clots, and individuals should seek medical care if they believe a blood clot exists.
What are blood clots?
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Blood is a liquid that flows within blood vessels. It is constantly in motion as the heart pumps blood through arteries to the different organs and cells of the body. The blood is returned back to the heart by the veins. Veins are squeezed when muscles in the body contract and push the blood back to the heart.
Blood clotting is an important mechanism to help the body repair injured blood vessels. Blood consists of: * red blood cells containing hemoglobin that carry oxygen to cells and remove carbon dioxide (the waste product of metabolism), * white blood cells that fight infection, * platelets that are part of the clotting process of the body, and * blood plasma, which contains fluid, chemicals and proteins that are important for bodily functions.
Complex mechanisms exist in the bloodstream to form clots where they are needed. If the lining of the blood vessels becomes damaged, platelets are recruited to the injured area to form an initial plug. These activated platelets release chemicals that start the clotting cascade, using a series of clotting factors produced by the body. Ultimately, fibrin is formed, the protein that crosslinks with itself to form a mesh that makes up the final blood clot.
The medical term for a blood clot is a thrombus (plural= thrombi). When a thrombus is formed as part of a normal repair process of the body, there is little consequence. Unfortunately, there are times when a thrombus (blood clot) will form when it is not needed, and this can have potentially significant consequences.
Reviewed by Melissa Conrad Stöppler, MD on 2/4/2013

Next: What causes blood clots? Blood Clots (cont.)

1. Heart Disease Slideshow Pictures 2. Medical Illustrations of the Heart Image Collection 3. Take the Heart Disease Quiz!
Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor:
Melissa Conrad Stöppler, MD
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In this Article * Blood clot facts * What are blood clots? * What causes blood clots? * What does a blood clot look like? * What are the risk factors for blood clots? * What types and conditions are caused by blood clots? * What are the symptoms of blood clots? * How are blood clots diagnosed? * What is the treatment for blood clots? * What are the complications of blood clots? * How can blood clots be prevented? * Patient Comments: Blood Clots - Describe Your Experience * Patient Comments: Blood Clots - Causes * Patient Comments: Blood Clots - Symptoms * Blood Clots Index
What does a blood clot look like?
Picture of a how blood clot is formed

What causes blood clots?
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Blood clots form when there is damage to the lining of a blood vessel, either an artery or a vein. The damage may be obvious, such as a laceration, or may occur on the microscopic level. As well, blood will begin to clot if it stops moving and becomes stagnant.
Venous thrombosis or blood clots in a vein occur when a person becomes immobilized and muscles are not contracting to push blood back to the heart. This stagnant blood begins to form small clots along the walls of the vein. This initial clot can gradually grow to partially or completely occlude or block the vein and prevent blood from returning to the heart. An analogy to this process is a slow moving river. Over time, weeds and algae start to accumulate along the banks of the river where the water flows more slowly. Gradually, as the weeds start to grow, they begin to invade the center of the river because they can withstand the pressure of the oncoming water flow.
Arterial thrombi (blood clots in an artery) occur by a different mechanism. For those with atherosclerotic disease, plaque deposits form along the lining of the artery and grow to cause narrowing of the vessel. This is the disease process that may cause heart attack, stroke, or peripheral artery disease. If a plaque ruptures, a blood clot can form at the site of that rupture and can completely or partially occlude the blood flow at that point.
Blood clots in the heart. In atrial fibrillation, the atrium or upper chamber of the heart does not beat in an organized manner. Instead, it jiggles, and blood tends to become stagnant along the walls of the atrium. Over time, this may cause small blood clots to form. Clots can also form in the ventricle after a heart attack when part of the heart muscle is injured and unable to contract normally. Since the damaged area doesn't contract with the rest of the heart, blood can start to pool or stagnate, leading to clot formation.
Blood leaking out of a blood vessel. Blood clots can form when blood leaks out of a blood vessel. This is very beneficial when a person gets a cut or scrape wound, because the clot helps stop further bleeding at the wound site. The clotting mechanism works well following trauma as well. Broken bones, sprains and strains, and nosebleeds all result in bleeding that is controlled by the body's clotting mechanism.
Blood clots causing other medical problems. Sometimes, normal blood clotting can cause medical problems because of its location. For example, if bleeding occurs in the urine from any of a variety of reasons (such as infection, trauma, or tumor) clots may form and prevent the bladder from emptying, causing urinary retention. Clot formation in the uterus may cause pain when the clots are passed through the cervix and can lead to vaginal bleeding, either as part of menstruation or as abnormal vaginal bleeding (menorrhagia, dysmenorrhea).
Reviewed by Melissa Conrad Stöppler, MD on 2/4/2013

Next: What are the risk factors for blood clots? Blood Clots (cont.)

1. Heart Disease Slideshow Pictures 2. Medical Illustrations of the Heart Image Collection 3. Take the Heart Disease Quiz!
Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor:
Melissa Conrad Stöppler, MD
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In this Article * Blood clot facts * What are blood clots? * What causes blood clots? * What does a blood clot look like? * What are the risk factors for blood clots? * What types and conditions are caused by blood clots? * What are the symptoms of blood clots? * How are blood clots diagnosed? * What is the treatment for blood clots? * What are the complications of blood clots? * How can blood clots be prevented? * Patient Comments: Blood Clots - Describe Your Experience * Patient Comments: Blood Clots - Causes * Patient Comments: Blood Clots - Symptoms * Blood Clots Index
What are the risk factors for blood clots?
The risk factors for arterial clots are those that are common to all diseases that cause narrowing of blood vessels, cholesterol plaque formation, and plaque rupture. * High blood pressure * High cholesterol levels * Diabetes * Smoking * Family history
Venous clots are formed due to one of two main reasons: 1) immobility, and 2) genetic errors in the clotting mechanism. 1. Immobility: Most commonly, when the body stops moving, the risk of blood clots increases, since muscle movement is required to pump blood towards the heart. Stagnant blood in a vein is prone to clot. * This may occur when a person is hospitalized or bedridden after illness or surgery. * It may also occur with long trips (such as in a car, train, or plane) where hours may pass without a person getting up to walk or stretch. * Orthopedic injuries and casting also put the person at risk. * Pregnancy is a risk factor for forming blood clots in the legs and pelvis, since the growing uterus may slow blood flow back to the heart to a sufficient extent that blood clots may form. 2. Genetic errors in the clotting mechanism: There may be a genetic or inborn error in the clotting mechanism, making a person hypercoagulable (hyper=more + coagulation= clotting) and at greater risk for forming clots.
Reviewed by Melissa Conrad Stöppler, MD on 2/4/2013

Next: What types and conditions are caused by blood clots?
Blood Clots (cont.)

1. Heart Disease Slideshow Pictures 2. Medical Illustrations of the Heart Image Collection 3. Take the Heart Disease Quiz!
Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor:
Melissa Conrad Stöppler, MD
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In this Article * Blood clot facts * What are blood clots? * What causes blood clots? * What does a blood clot look like? * What are the risk factors for blood clots? * What types and conditions are caused by blood clots? * What are the symptoms of blood clots? * How are blood clots diagnosed? * What is the treatment for blood clots? * What are the complications of blood clots? * How can blood clots be prevented? * Patient Comments: Blood Clots - Describe Your Experience * Patient Comments: Blood Clots - Causes * Patient Comments: Blood Clots - Symptoms * Blood Clots Index
What types of conditions are caused by blood clots?
Blood clots may cause life-threatening medical conditions, and are always considered in the differential diagnosis of any symptoms or signs. Differential diagnosis is the list of potential causes of a patient's condition, that is considered by the health care practitioner when caring for a patient.
Deep venous thrombosis and pulmonary embolism
Deep venous thrombosis may lead to a pulmonary embolism. If there is a blood clot or thrombus in a deep vein, it has the potential to break off (embolize) and flow through the veins back through the heart, and into the lung where it can become lodged in a small blood vessel, which prevents the lung from functioning. Pulmonary embolism is a medical emergency and can cause serious illness or death.
An embolus is the medical term for a blood clot that has moved with the bloodstream to a different location. With pulmonary embolus (pulmonary embolism), two issues occur. 1. The lungs' blood supply is comprised and the affected area of lung tissue may infarct, or die. 2. Because of the blockage, the ability of the lung to provide oxygen to the body is decreased and hypoxia (decreased levels of oxygen in the blood and throughout the body) may occur.
Even if venous blood clots do not embolize, they may cause significant local problems with swelling and pain. Since blood cannot return to the heart if a vein is blocked by a clot, the limbs may chronically swell and have decreased function in a condition called chronic thrombophlebitis.
Arterial thrombus
An arterial thrombus stops the blood supply to the tissues beyond the blockage, depriving cells of oxygen and nutrients. This quickly leads to tissue death. Arterial thrombus is the mechanism that causes: * heart attack (when it occurs in the coronary arteries that supply blood to the heart) * stroke (when it occurs in arteries within the brain), or * peripheral vascular disease (occurring in the arteries of the legs).
Atrial fibrillation
In atrial fibrillation, small clots may form along the walls of the atrium or the upper chambers of the heart. Should one of these clots break off, it may embolize, or travel in the bloodstream to the brain, blocking an artery and causing a stroke. Other arteries may also be involved by this process, including those that supply the bowel. This can cause mesenteric ischemia (mesentery=lining of the bowel + ischemia=loss of blood supply) and potential necrosis (tissue death) of the intestine. Clots can also affect blood supply to fingers and toes.
Blood should clot anytime it becomes stagnant. This also means that clots will form when blood leaks out of blood vessels.
Examples include some of the following: * With bleeding peptic ulcers, patients may vomit liquid blood mixed with clot. * Patients with rectal bleeding may also have clot mixed with the bloody stool if there has been time for the clot to form. * Sometimes patients with urinary tract or bladder infections develop associated bleeding in their urine, and small clots can form. On occasion these clots may be so big that they cannot be passed and block the urethra, preventing urination and causing urinary retention. * Vaginal bleeding is a normal event for most women in the reproductive years and occasionally, blood can pool in the vagina and form clots before being expelled. If clots form in the uterus, they may cause significant pain and pressure as they pass through the cervix while being expelled.
Reviewed by Melissa Conrad Stöppler, MD on 2/4/2013

Next: What are the symptoms of blood clots? Blood Clots (cont.)

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Benjamin Wedro, MD, FACEP, FAAEM
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Melissa Conrad Stöppler, MD
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In this Article * Blood clot facts * What are blood clots? * What causes blood clots? * What does a blood clot look like? * What are the risk factors for blood clots? * What types and conditions are caused by blood clots? * What are the symptoms of blood clots? * How are blood clots diagnosed? * What is the treatment for blood clots? * What are the complications of blood clots? * How can blood clots be prevented? * Patient Comments: Blood Clots - Describe Your Experience * Patient Comments: Blood Clots - Causes * Patient Comments: Blood Clots - Symptoms * Blood Clots Index
What are the symptoms of blood clots?
Comment on this Read 1 Comment Share Your Story
Venous clots do not allow blood to return to the heart and symptoms occur because of this damming effect. Most often occurring in the legs or the arms, symptoms include: * swelling, * warmth, * redness, and * pain.
Arterial clots do not allow blood get to the affected area. Body tissue that is deprived of blood and oxygen begins to die and becomes ischemic (isch=to restrain + emia = blood) * Pain is the initial symptom of the ischemia, or oxygen deprivation due to loss of blood supply. * Other symptoms depend upon the location of the clot, and often the effect will be a loss of function. Heart attack and stroke are self-explanatory. * In an arm or leg, in addition to pain, the limb may appear white, and weakness, loss of sensation, or paralysis may occur. * If the blood supply is lost to an area of the bowel, in addition to intense pain, there may be bloody diarrhea.
How are blood clots diagnosed?
The initial step in making the diagnosis of a blood clot is obtaining a patient history. The blood clot itself does not cause a problem. It's the location of the blood clot and its effect on blood flow that causes symptoms and signs. If a blood clot or thrombus is a consideration, the history may expand to explore risk factors or situations that might put the patient at risk for forming a clot.
Venous blood clots often develop slowly with a gradual onset of swelling, pain, and discoloration. Symptoms of a venous thrombus will often progress over hours.
Arterial thrombi occur as an acute event. Tissues need oxygen immediately, and the loss of blood supply creates a situation in which symptoms begin immediately.
There may be symptoms that precede the acute artery blockage, that may be warning signs of the potential future complete occlusion of the blood vessel. * Patients with an acute heart attack (myocardial infarction) may experience angina in the days and weeks prior to the heart attack. * Patients with peripheral artery disease may have pain with walking (claudication), and a TIA (transient ischemia attack, mini-stroke) may precede a stroke.
Physical examination can assist in providing additional information that may increase the suspicion for a blood clot. * Venous thrombi may cause swelling of an extremity. It may be red, warm, and tender; sometimes the appearance is difficult to distinguish from cellulitis or an infection of the extremity. If there is concern about a pulmonary embolus, the clinician may examine the lungs, listening for abnormal sounds caused by an area of inflamed lung tissue. * Arterial thrombus symptoms are much more dramatic. If a leg or arm is involved, the tissue may be white because of the lack of blood supply. As well, it may be cool to touch and there may be loss of sensation and movement. The patient may be writhing in pain.
Arterial thrombus is also the cause of heart attack (myocardial infarction) and stroke (cerebrovascular accident) and their associated symptoms.
Testing for venous blood clots
Venous blood clots may be detected in a variety of ways, though ultrasound is most commonly used. Occasionally, the patient's size and shape limit the ability for ultrasound to provide a definitive answer.
Venography is an alternative test to look for a clot. In this test, a radiologist injects contrast dye into a small vein in the hand or foot and using fluoroscopy (video X-ray), watches the dye fill the veins in the extremity as it travels back to the heart. The area of clot or obstruction can thus be visualized.
Sometimes, a blood test is used to screen for blood clots. D-Dimer is a breakdown product of a blood clot, and its levels in the bloodstream may be measured. Blood clots are not stagnant; the body tries to dissolve them at the same time as new clot is being formed. D-Dimer is not specific for a blood clot in a given area and cannot distinguish a "good” or needed blood clot, one that forms after surgery or due to bruising from a fall, from one that is causing medical problems. It is used as a screening test with hopes that the result will be negative and show that there is no need to look further for blood clots.
The D-dimer blood test is usually ordered with the expectation that it will be negative. It is a useful test in patients who have a low probability of having a blood clot, and the health care practitioner usually counsels the patient that a positive blood test will likely require additional tests being ordered.
Should a blood clot embolize to the lung, this may be a medical emergency. There are a variety of tests to look for pulmonary emboli. A plain chest X-ray will not show blood clots, but it may be done to look for other conditions that can cause chest pain and shortness of breath, which are the symptoms of a pulmonary embolus. An electrocardiogram (EKG) may show abnormalities suggestive of a pulmonary embolus and also may reveal other causes of chest pain.
Computerized tomography (CT scan) is often the test of choice when suspicion of pulmonary embolus is high. Contrast material is injected intravenously, and the radiologist can determine whether a clot is present in the pulmonary vessels. The contrast material injected into the body can be irritating to the kidney(s) and should not be used in patients who have impaired kidney function. In older patients, screening blood tests (serum creatinine) to check kidney function may be required before a dye study is considered.
On occasion, a ventilation perfusion (V/Q) scan is performed to look for pulmonary emboli. This test uses labeled chemicals to identify inhaled air into the lungs and match it with blood flow in the arteries. If a mismatch occurs, meaning that there is lung tissue that has good air entry but no blood flow, it may be indicative of a pulmonary embolus. It is less accurate and more subjective than a CT scan, and requires the skill and experience of a radiologist to interpret. Two radiologist may interpret a VQ scan differently and come to different conclusions.
Testing for arterial blood clots
Arterial thrombosis is an emergency, since tissue cannot survive long without blood supply before there is irreversible damage. When this occurs in an arm or leg, often a surgeon is consulted on an emergency basis. Arteriography may be considered, a test in which contrast material is injected into the artery in question to look for blockage on imaging studies. Sometimes, if there is a large artery that is occluded, this test is done in the operating room with the presumption that a surgical procedure will be needed to open the vessel and restore blood flow.
For a heart attack (acute myocardial infarction, MI), the EKG may establish the diagnosis, although blood tests may be used to look for enzymes (troponin, myoglobin, CPK) that leak into the bloodstream from irritated heart muscle. In an acute heart attack, the diagnostic and therapeutic procedure of choice is a heart catheterization.
For an acute stroke (cerebrovascular accident, CVA), the test of choice is a computerized tomography (CT) scan of the head to look for bleeding or tumor as the cause of stroke symptoms. If the symptoms resolve, the diagnosis is a transient ischemic attack (TIA, mini-stroke), and further tests may include carotid ultrasound to look for blockages in the major arteries of the neck and echocardiography to look for blood clots in the heart that may embolize to the brain.
Reviewed by Melissa Conrad Stöppler, MD on 2/4/2013

Next: What is the treatment for blood clots? Blood Clots (cont.)

1. Heart Disease Slideshow Pictures 2. Medical Illustrations of the Heart Image Collection 3. Take the Heart Disease Quiz!
Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor:
Melissa Conrad Stöppler, MD
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In this Article * Blood clot facts * What are blood clots? * What causes blood clots? * What does a blood clot look like? * What are the risk factors for blood clots? * What types and conditions are caused by blood clots? * What are the symptoms of blood clots? * How are blood clots diagnosed? * What is the treatment for blood clots? * What are the complications of blood clots? * How can blood clots be prevented? * Patient Comments: Blood Clots - Describe Your Experience * Patient Comments: Blood Clots - Causes * Patient Comments: Blood Clots - Symptoms * Blood Clots Index
What is the treatment for blood clots?
Depending upon their location, blood clots may be aggressively treated or may need nothing more than symptomatic care.
Venous blood clots
Venous thrombosis in the leg may occur in the superficial or deep systems of veins.
Clots in the superficial system are often treated symptomatically with warm compresses and acetaminophen or ibuprofen since there is no risk for clots in the superficial veins to embolize to the lung. They are connected to the deep system by perforator veins that have valves that act like a sieve to strain and prevent any clots form getting to the lung.
Deep venous thrombosis usually requires anticoagulation to prevent the clot from growing and causing a pulmonary embolus. Initial therapy with injectable enoxaparin (Lovenox) is used to immediately "thin" the blood. Meanwhile, warfarin (Coumadin) is prescribed as an anti-coagulation pill. It takes a few days for warfarin to reach therapeutic levels and in this time frame, both the injectable and oral medications are used. Most often, patients with DVTs are treated as an outpatient and taught how to give themselves enoxaparin (Lovenox) injections. Occasionally, depending upon circumstances, patients may be admitted to the hospital for an unfractionated heparin intravenous (IV) injection.
Blood clots below the knee are at lower risk for embolization to the lung, and an alternative to anti-coagulation treatment is serial ultrasound examinations to monitor the clot to see if it is growing or being resorbed by the body.
Pulmonary emboli are treated similarly to deep venous thrombosis, but depending on the severity of the symptoms, amount of clot formation, and the underlying health of the patient, admission to the hospital for treatment and observation may be needed. This is especially the case if lung function is compromised and the patient is short of breath or is experiencing hypoxia, or low oxygen levels in the blood.
Arterial blood clots
Arterial blood clots are often managed more aggressively. Surgery may be attempted to remove the clot, or medication may be administered directly into the clot to try to dissolve it. Alteplase (Activase, TPA) or tenecteplase (TNKase) are examples of medications that may be used in peripheral arteries to try to restore blood supply.
This is the same approach that is used for heart attack. If possible, cardiac catheterization is performed to locate the blocked blood vessel and a balloon is used to open the occluded area, restore blood flow, and place a stent to keep it open. This is a time-sensitive procedure and if a hospital is not available to do the procedure emergently, TPA or TNK is used intravenously to try to dissolve the thrombus and minimize heart damage.
Stroke is also treated with TPA if the patient is an appropriate candidate for this therapy.
Reviewed by Melissa Conrad Stöppler, MD on 2/4/2013

Next: What are the complications of blood clots? Blood Clots (cont.)

1. Heart Disease Slideshow Pictures 2. Medical Illustrations of the Heart Image Collection 3. Take the Heart Disease Quiz!
Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor:
Melissa Conrad Stöppler, MD
Share this Article:
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In this Article * Blood clot facts * What are blood clots? * What causes blood clots? * What does a blood clot look like? * What are the risk factors for blood clots? * What types and conditions are caused by blood clots? * What are the symptoms of blood clots? * How are blood clots diagnosed? * What is the treatment for blood clots? * What are the complications of blood clots? * How can blood clots be prevented? * Patient Comments: Blood Clots - Describe Your Experience * Patient Comments: Blood Clots - Causes * Patient Comments: Blood Clots - Symptoms * Blood Clots Index
What are the complications of blood clots?
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Blood clots prevent proper circulation of blood.
Deep vein thrombosis of the leg or arm may cause permanent damage to the veins themselves and cause persistent swelling of the extremity. The life-threatening issue that may arise from deep venous clots is a clot that breaks off and embolizes to the lungs (pulmonary embolus), causing problems with lung function and oxygenation of the blood.
Arterial thrombus often is a life- or limb threatening event, since organs and cells do not get enough oxygen.
How can blood clots be prevented?
Prevention is key in thrombosis or clot formation.
Arterial thrombosis * For arterial thrombosis, the most likely precipitating event is a plaque rupture with clot formation in the artery. * Minimizing the risk of vascular disease requires life-long attention to the risk factors that lead to plaque buildup and "hardening" of the arteries. * Blood pressure and cholesterol control, diabetes management, and refraining from smoking all minimize the risk of arterial disease. * Although family history is an important risk factor, one needs to be even more vigilant about the other risk factors if there is a family history of early heart attack or stroke.
Deep vein thrombosis
The main risk factor for deep vein thrombosis risks is immobilization. It is important to move around routinely so that blood can circulate in the venous system. On long trips, it is recommended to get out of the car every couple of hours and in an airplane routinely get up and stretch.
Physicians and nurses work hard at getting people moving after surgery or while in the hospital for medical conditions. The low molecular weight heparin known as enoxaparin (Lovenox) can also be used in low doses to prevent clot formation. Patients are often given tight stockings to promote blood return from the legs and prevent pooling of blood.
In patients with atrial fibrillation, warfarin (Coumadin) was traditionally used to prevent clot formation and minimize the risk of embolus and stroke. Newer medications have been developed that prevent blood clot formation similar to warfarin and have been successfully used in patients with atrial fibrillation. These medications include dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis). These newer drugs have advantages of reduced susceptibility to diet and drug interactions and convenience (lack of need for routine blood testing of the international normalized ratio or INR, as is required for warfarin therapy).
An important caution was issued by the FDA about the use of dabigatran because a clinical trial in Europe (the RE-ALIGN trial)1 was recently stopped because dabigatran users were more likely to experience strokes, heart attacks, and blood clots forming on the mechanical heart valves than were users of warfarin. There was also more bleeding after valve surgery with dabigatran use than with the use of warfarin. The FDA recommends that dabigatran not be used to prevent blood clots in patients with mechanical prosthetic heart valves.
REFERENCE:

eMedicine.com. Deep Vein Thrombosis and Thrombophlebitis.
<http://emedicine.medscape.com/article/758140-overview.>

Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed. United States: McGraw-Hill Professional, 2008.

Reviewed by Melissa Conrad Stöppler, MD on 2/4/2013

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Comment from: (Patient) Published: October 06
It started with just a strain in my neck which proceeded to a horrible pain in my right neck to the point of immobilization. Then I had difficulty in breathing that proceeded in me not being able to breath at all. After finally seeing the Dr. and receiving a CT scan, the results showed 3 blood clots in my right lung. I'm a rare case in that I was very gaseous - still to this day. No reason has been given to this - though it only began when the blood clots had formed. I'm still not cured and am still taking Coumadin. It was a horrible experience that I NEVER want to go through again. I spent a week, my Birthday, in the Hospital.
Comment from: Cat, 55-64 Female (Patient) Published: October 06
I was diagnosed with Fibromyalgia 5 years ago. I blame my 60 pound weight gain on the medication and the exhaustion that looking back now caused me to stay in bed. The top cause for blood clots is weight, but still I never thought it could happen to me. I have been trying to keep moving, even water exercises almost daily. One day I went to a doctor's appointment and decided I would walk in the mall. I noticed after a short time that I was sweating so severely, my hair was soaking wet and the sweat was pouring. I tried to ignore the throbbing chest pain as I was told it has been proven that a person can suffer from chest muscle wall pain of Fibromyalgia. The more I attempted to walk, I just knew something was going on. I made it home and the symptoms didn't go away~~In fact, I started having stomach cramps followed by diarrhea. A little voice inside me told me I should go to the hospital. My EKG was normal and the nurse talked like I would be going home. Thank God one of the ER doctors decided to do a lung CAT scan. The nurse came in and said "you are not going anywhere". I spent 4 days in ICU because they found an embolism in both lungs. I was put on Coumadin and oxygen 24/7. (I use a C-Pap machine for sleep apnea). It has been 7 days and the home health nurses keep telling me that my PT shows my blood two thin. I have learned a lot from reading all of the comments. I thank all of you who took the time to help us "newcomers" understand. Obviously I am on a strict diet and I am committed to losing the weight. I have discontinued the Lyrica for Fibromyalgia and Amitriptyline for anxiety.
Related Medications: Amitriptyline
Comment from: 35-44 Male (Caregiver) Published: October 06
My husband,42, went to the er for a small toe infection (we think a spider bit him) and it turned out to be serious because of his uncontrolled diabetes. He had to have surgery on the toe to remove the infection and was in the hospital for 6 days because of diabetes complications. He was put on insulin for the first time. (I wish we went on insulin sooner) Anyhow, while he was in the hospital, he didn't get up to walk at all. He was just laying in the hospital bed with his foot up. When he went home, he kept his foot up also. I think this is why he got the blood clot. A few days later the nurse came to change his bandages and noticed one foot was colder than the other and she said it might be a blood clot. (also he was using crutches and had to keep his left leg bent in order to get around.) We went to the er and sure enough they admitted him and said he had a blood clot on his lower leg. They kept him in the hospital for about 3 days this time. The hospital was wonderful and this time he will definitely watch his diet. He went home and is now on insulin, Lovenox shots 2x daily and also Warfarin 1 1/2 a day. His INR keeps changing slightly because he ran out of Lovenox shots at one point. At one point he was off Lovenox but just recently had to take them again. Anyhow, we have a great doctors office that is monitoring it so I hope all goes well. Also he was drinking lots of Green Tea which I think is High in Vitamin K. So I think I missed this when I was reading the things not to eat. I read everything but didn't catch the Green tea till my nurse sent me another book. so no green tea if you're on warfarin. Thanks MedicineNet.
Related Medications: insulin | Warfarin | Green Tea
Comment from: 35-44 Male (Patient) Published: October 06
Hi I have had heart attacks strokes from blood clots. The doctors couldn't figure out why i was having heart attacks at my age my arteries were clear. They did a test and found I had Antiphospholipid Antibody Syndrome (APS). This syndrome causes your blood to clot in woman it causes mischarges. I was put on warfarin and have to stay on it for the rest of my life. I recently was bleeding out in to my lungs and the cavity around the heart they took me of blood thinners and i threw a clot destroying left arm making it useless. I have had a nightmare and continued one as im sure all of u have. If you feel something is wrong and if u think your doctor isn't listening then see another this has saved my life and my family and friends.
Patient Comments: Blood Clots - Describe Your Experience

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Comment from: ducksoup, 45-54 Female (Patient) Published: March 21
I was able to walk up to five miles and no problem. But then I noticed I could not breathe very well after any activity. I slept a lot. I also had knee surgery after falling 15 feet. I urged my husband to take me to hospital in the morning after I could not breathe very well. The doctors said I had anxiety. Ativan didn't help. An X-ray revealed pulmonary embolisms in both lungs. I was hospitalized and put on other medications. These caused seizures. I was released to a Coumadin clinic. I'm now on 81 mg of aspirin per day. I worry every day that I'll have another PE. Any support would help me.
Comment from: shartmac, 35-44 Female (Patient) Published: October 06
I was diagnosed with a blood clot earlier this year in late March, right before my 37th birthday. I went to a walk in clinic with a swollen right arm, and once the physician on duty saw the sight of my arm she sent me to the ER immediately. The next couple of days involved sitting in the ER, waiting for test after test to be done, having my blood drawn, etc... Now, six months later, the clot is gone but the oncologist who treated me at the hospital seems to think that I need to stay on the warfarin I've been taking up until now and refer me to another specialist. I am so frustrated. If it's gone, then why do I need to stay on this path? There was no clear reason or cause as to why I developed the clot in the first place. I wish I had more answers and that someone out there could explain this to me. The oncologist kept saying something about a reoccurrence and other such things.
Comment from: Nzinga, 35-44 Male (Caregiver) Published: October 06 my brother was involved in a motorcycle accident. He broke his pelvis both sockets replaced thigh bone leg ankle foot. Titanium plates and rods put in the broken parts mentioned. By not being mobile a blood clot developed in his upper rt thigh. This leg was in a cast, and as the blood clot became obvious the leg in the cast became tight. The cast had to be replaced with a loser one. he has been on blood thinners. But becoming able to move is crucial, but this clot situation has to be resolved.
Comment from: troutfisher, 55-64 Male (Patient) Published: October 06
I have been on Coumadin (warfarin) and was getting ready for a defibrillator, A.V. node ablation. I had a small stroke last Thurs. night and was rushed to hospital. After finding my protime no. to be right they further experimented and found I have Lupus anticoagulin disorder. Now on Lovenox shots. I understand I do not go in for pro time analysis. I read info on Lovenox and says don't mix with aspirin but they have me on low dose aspirin also?
Comment from: Anna, 35-44 Female (Patient) Published: August 17
I fell on the stairs of my home. I didn't really hit or bruise my arm, just extended it to prevent my fall. The next day my arm was sore. I thought I pulled a muscle. The next day the soreness was worse. On the 3rd day I could hardly move my arm. On the 4th day I could not comb my hair, it was very painful and swelling. It had redness and was hot to the touch. Finally, I went to the doctor. I had a sonogram and it determined I had a clot. The doctor wanted me in the hospital, but my husband could not be left alone. I gave my self shots of Loveonox prescribed by doctor at home. I later had a clot in other arm and behind my left knee. The Lovenox worked and I am still taking a pill and a half a day of Coumadin. Blood work weekly to keep check on thickness of my blood. Hopefully can get answers why I had the clots. Have not been sick or to a doctor in 3 or 4 years.
Comment from: NickieA71, 35-44 Female (Patient) Published: August 17
I was recently diagnosed with a pulmonary embolism. I don't have any of the risk factors and they don't know what caused it. I suffer from chronic resistant migraines, though the doctors don't think this has anything to do with the PE. I was prescribed Lovenox in the hospital and will continue taking it for six months as I may become pregnant because I am not on birth control. Lovenox is apparently okay during pregnancy, warfarin is not.
Comment from: river rat 46, 55-64 Male (Patient) Published: July 31
My lower right calf muscle felt sore. After about two weeks I began having bad pain in my chest especially when I coughed. This kept getting worse and I thought I was having a heart attack so I went to my doctor. I was not able to get a good breath and thought I would smother and also had intense pain in the left shoulder. My left arm didn't have any strength. I had a DVT with a pulmonary embolism in each lung. I have been on warfarin since December 2nd. I am getting a blood test next month and I might not have to take it any longer.
Patient Comments: Blood Clots - Describe Your Experience

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Comment from: 19-24 Female (Patient) Published: July 15
When I was 12 years old I got a D.V.T in my left groin area the cause was unknown to the doctors and they did so many tests it was very scary. The only conclusion they could come to was a long car ride I had taken a week before. Now when you have a D.V.T too you are supposed to be in bed no walking well they allowed me to and it moved to my lungs I had to take Coumadin for 6 months and give myself shots in the stomach for a week.
Comment from: happymom, 25-34 Female (Patient) Published: June 26
At the age of 27 I gave birth to a healthy baby girl. A few hours after giving birth I started to have a really bad headache, I mentioned it to the nurse and she said it was from the epidural I had received so I let it go. 2 days later I couldn't even open my left eye from the pain being so bad. I decided to go to the emergency room where the doctor said it was just because I wasn't getting enough sleep. 10 days later the left side of my head was still hurting, now along with the left side of my neck. My husband noticed I was now crying, vomiting and in severe pain, he decided to call 911. When I arrived to the emergency room they ran some MRI's and CT scan, finally I had an answer, I had a cerebral blood clot along with a blood clot in my jugular. I was given heparin, lovenox and Coumadin in that order. I'm very thankful to be alive even though I do have some permanent damage.
Comment from: Talavera1, 35-44 Female (Patient) Published: May 13
I had just given birth to my baby girl in 1998. In April of 1999, I was diagnosed with Hepatitis C. In December of 1999, I had a full-blown ischemic stroke due to a venous clot, and I was only 31. I was extremely blessed in that I fully recovered with great medical care and was put on Plavix. In March of this year, I turned 40 and my daughter is 10. Please: Never, ever think you're totally immune to what typically is considered "elderly" medical problems. Blood clots are no laughing matter at any age!
Comment from: Baje, 45-54 Male (Caregiver) Published: March 12
My friend is on the blood thinner warfarin. This is the third time his medication has increased and still his blood is thick. He never had a clot in his leg but somewhere in is lungs.
Comment from: awbsmom, 19-24 Female (Patient) Published: October 12
I am 24 and had my second child Sept. 12th. Got home from the hospital and felt great. On the 22nd I had extreme pain in my inner thigh brushed it off as nothing. On the 24th I noticed my entire left leg including calf was swollen. Went to the ER and I had a blood clot. I am 24 and have a new baby and a 4yr old to take care of. It is a serious situation and I do feel like an elderly person who can't move. I have a new found respect for these serious situations.
Comment from: Reesa Long, 35-44 Female (Patient) Published: October 06
I had been donating plasma for almost 3 weeks when i went in one day to donate they started my cycle and my blood was not moving. They thought it was just thick and so they disconnected the tube and ran the blood out. It was clotted. The moved the needle to my other arm and blood started to flow but very slowly. When the cycle started to replace my blood my other arm clotted. I have no idea why my blood is clotting but it is pretty scary.
Comment from: karlyg, 55-64 Female (Patient) Published: September 25
I had severe pain in the lower left rib cage area and in both arms and shoulders. It wasn't taken too seriously until I also exhibited shortness of breath. The emergency-room doctor told me I had several blood clots -- most of them in my right lung, but none were found elsewhere. I am being treated with 5 mg of Coumadin daily.
Comment from: nlmartinez, 65-74 Female (Patient) Published: September 25
I had my knee replaced three years ago, and I got an infection in it, so I was in the hospital for two months. It was then that I got a deep-vein blood clot. I have been on Lovenox ever since; I give myself a shot every day. Patient Comments: Blood Clots - Describe Your Experience

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Comment from: Liz, 55-64 Female (Patient) Published: June 26
After a second ACL replacement on the same knee I mentioned to the physicians assistant how white my leg was when the bandage was cut off. After the first surgery there was a lot of bruising. 20 minutes after removal of the bandage I had a stroke. The clot snuck through a pfo or hole in the septum of my heart. Luckily for me I was close to Hartford Hospital where they were able to use the Merci procedure to break up the rather large clot.
Comment from: angle4u28, 35-44 Female (Patient) Published: May 13
I had pain in my shoulder and mid back for about three days. One night, the pain got worse, and I was short of breath. I went to the hospital, and they found the blood clot in my right lung. They are still trying to figure out why I got one. I am not high risk for a blood clot.
Comment from: Bobbie, 55-64 Female (Patient) Published: May 01
In my experiences with blood clots in the leg, the first symptom was pain in my leg that felt like a strained muscle. When I had pulmonary thrombosis, the first symptom was pain in the left rib area that worsened when I took a breath.
Comment from: obrien, 35-44 Female (Patient) Published: August 17
I had my first pulmonary emboli at aged 22 I am now 37 and have had in total 4 clots in the lungs even though I have been on Warfarin and Innohep injections for over 14 years. I'm still undergoing investigation as to where the underlying problem is. I am hoping to discuss the solution of a filter being fitted due to the ongoing problems that can be faced when on long term anti-coagulants.
Comment from: sugdaro2005, 35-44 Female (Patient) Published: August 17
I woke up one morning and my left arm was swollen to my finger tips. I got scared and went to the ER. This past March I had a defibrillator/pacemaker put in. So 2 weeks ago, my left arm swelled up, and they said it was a blood clot, they put me on warfarin, and they are monitoring me at my doctor's office. I didn't have a fever, but my oxygen level was down.
Comment from: forgio, 55-64 Female (Patient) Published: July 31
I recently received a steroid injection in my right foot and within 3 days was in the hospital with several bi-lateral PE in my lungs. I can't help but wonder if this injection may have caused my PE's. I never had a steroid injection before this. I am currently taking Warfarin and will be on it for the rest of my life because they could not confirm where the blood clot came from.
Comment from: Jim, 45-54 Male (Patient) Published: July 31
I first experienced my blood clot as muscle soreness in my inner thigh, and then my calf and behind the knee. What made the soreness unusual was that the site of the soreness seemed to move around in my calf and up to behind my knee and back down to the calf again. My calf then started to swell. I ignored these symptoms because I had recently had a painful knee bruise, and figured the soreness and swellings were due to the knee injury. I also developed a light fever of around 100-100.6 degrees which would come and go. I still did not consult a doctor, because I was also dealing with having my hyperthyroidism treated, and wondered if these signs were all symptoms of my thyroid slowing down. The symptoms did not go away after two-three weeks, and I finally saw my doctor. He sent me to get a Doppler ultrasound of my leg, and sure enough, I had a very large blood clot extending from my upper thigh through to my calf. I spent three days in the hospital being treated with Lovenox and Coumadin, and was told by the treating hematologist that I was very lucky that I had not had a pulmonary embolism. I am still on Coumadin and am undergoing tests to determine a possible cause to the blood clot.
Comment from: MR, 75 or over Male (Caregiver) Published: July 31
My 81 year old father developed a blood clot in his right leg in January. He was hospitalized and put on blood thinners being monitored weekly for levels. Following a routine colonoscopy in March, he became weaker, and developed headaches. After a CT scan, he was diagnosed with two blood clots on each side of the brain late in March. They inserted the filter in his abdomen to catch further clots, and had surgery which involved 4 buhr holes. He recooperated, with routine CT scans, and in June was diagnosed with yet another blot clot on the brain and bleeding. Following surgery, he developed seizures, weakness on the right side, and slurred speech. All have subsided, and he continues to recover in the hospital, however his hemoglobin levels have fluctuated between 8.9 and 10.4, and is very tired. We're told this is normal. He is not on any blood thinne Patient Comments: Blood Clots - Describe Your Experience

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Comment from: ptg, 55-64 Male (Patient) Published: July 15
The day before my "attack" I was extremely tired and had difficulty walking a short distance. The next evening I developed an excruciating pain in the right side of my chest which I thought to be a heart attack. I was diagnosed with a pulmonary embolism and, after tests, eventually prescribed warfarin, which I will be taking from now on. The reason for the blood clot was probably due to an irregular heartbeat and originated in my leg.
Comment from: Giani, 45-54 Male (Patient) Published: May 29
I had severe pain in my left arm. Pain increased with every movement of left hand or arm. Felt some relief in the sun or when arm was kept warm. Pain killers became ineffective after a few days. Ultimately a block was diagnosed near my throat. While operating it was discovered that the clotting started from very near to heart up to throat and blood in left arm was totally blocked while supply to the brain continued. The block was cleared by Operation. There was again pain in left arm. Again a block was diagnosed in left arm. This time operation was ruled out. It was managed with drugs to generate new blood vessels. Slowly blood supply was just sufficient for my arm to perform daily routine though limited to around 30%. I don't know when and where it is going to hit again.
Comment from: lee, 25-34 Female (Patient) Published: May 29
My blood clot hit me when I was in the shower, I could not get to the phone and it was 3 hours before I was found. When I was at the hospital I could not tell the staff my history. I had had a heart attack 5 years earlier it was a blood clot also, to cut the story short I am now a disabled person and the cause has been found. I have an inherited blood condition. Gene 2 Factor V Leiden mutation. G1691A.Our family has 50% that has this mutation and all have been tested. I think every woman should be tested as the risk is very high for woman when having children.

High Blood Pressure
(Hypertension)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town
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High Blood Pressure Medications
Pharmacy Author: Omudhome Ogbru, PharmD
Medical Editor: Jay W. Marks, MD
High blood pressure medications include drugs from the ACE inhibitor, ARB (angiotensin receptor blockers), beta blockers, calcium channel blockers (CCBs), diuretics, alpha-blockers, alpha-beta blockers drug classes. Clonidine (Catapres) and minoxidil are also drugs prescribed for the treatment of high blood pressure. Side effects, warnings and precautions, safety information, and pregnancy safety information should be reviewed prior to taking any medication. * ACE inhibitors * Angiotensin receptor blocker (ARB) * Beta-blockers * Calcium channel blockers (CCBs) * Diuretics * Alpha-blockers * Alpha-beta blockers * Clonidine * Minoxidil
Learn more about high blood pressure medications »
High blood pressure facts * High blood pressure (hypertension) is designated as either essential (primary) hypertension or secondary hypertension and is defined as a consistently elevated blood pressure exceeding 140/90 mm Hg. * High blood pressure is called "the silent killer" because it often causes no symptoms for many years, even decades, until it finally damages certain critical organs. * Poorly controlled high blood pressure ultimately can cause damage to blood vessels in the eye, thickening of the heart muscle and heart attacks, hardening of the arteries (arteriosclerosis), kidney failure, and strokes. * Most antihypertensive medications can be used alone or in combination. Some are used only in combination. Some are preferred over others in certain specific medical situations. And some are not to be used (contraindicated) in other situations. * Several classes of antihypertensive medications are available, including ACE inhibitors, ARB drugs, beta-blockers, diuretics, calcium channel blockers, alpha-blockers, and peripheral vasodilators. * The goal of therapy for hypertension is to bring the blood pressure down below 140/85 in the general population and to even lower levels in diabetics, African Americans, and people with certain chronic kidney diseases. * High blood pressure (hypertension) in pregnancy can lead to preeclampsia or eclampsia (toxemia of pregnancy). Pregnant women should be monitored closely by their obstetrician for complications of high blood pressure. * Lifestyle adjustments in diet and exercise and compliance with medication regimes are important factors in determining the outcome for people with hypertension. * High salt intake, obesity, lack of regular exercise, excessive alcohol or coffee intake, and smoking may all adversely affect the outlook for the health of an individual with high blood pressure.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: What is high blood pressure? High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
What is high blood pressure?
Comment on this Read 3 Comments Share Your Story
High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.
The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.
An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.
It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.
The American Heart Association estimates high blood pressure affects approximately one in three adults in the United States -- 73 million people. High blood pressure is also estimated to affect about two million American teens and children, and the Journal of the American Medical Association reports that many are underdiagnosed. Hypertension is clearly a major public health problem.

Reviewed by Jay W. Marks, MD on 4/11/2012

Next: How is the blood pressure measured? High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
How is the blood pressure measured?
The blood pressure usually is measured with a small, portable instrument called a blood pressure cuff (sphygmomanometer). (Sphygmo is Greek for pulse, and a manometer measures pressure.) The blood pressure cuff consists of an air pump, a pressure gauge, and a rubber cuff. The instrument measures the blood pressure in units called millimeters of mercury (mm Hg).
The cuff is placed around the upper arm and inflated with an air pump to a pressure that blocks the flow of blood in the main artery (brachial artery) that travels through the arm. The arm is then extended at the side of the body at the level of the heart, and the pressure of the cuff on the arm and artery is gradually released. As the pressure in the cuff decreases, a health practitioner listens with a stethoscope over the artery at the front of the elbow. The pressure at which the practitioner first hears a pulsation from the artery is the systolic pressure (the top number). As the cuff pressure decreases further, the pressure at which the pulsation finally stops is the diastolic pressure (the bottom number). Measurement of blood pressure can also be done with electronic machines that automatically inflate the cuff and recognize the changes in pulsations.

How is high blood pressure defined?
Blood pressure can be affected by several factors, so it is important to standardize the environment when blood pressure is measured. For at least one hour before blood pressure is taken, avoid eating, strenuous exercise (which can lower blood pressure), smoking, and caffeine intake. Other stresses may alter the blood pressure and need to be considered when blood pressure is measured.
Even though most insurance companies consider high blood pressure to be 140/90 and higher for the general population, these levels may not be appropriate cut-offs for all individuals. Many experts in the field of hypertension view blood pressure levels as a range, from lower levels to higher levels. Such a range implies there are no clear or precise cut-off values to separate normal blood pressure from high blood pressure. Individuals with so-called pre-hypertension (defined as a blood pressure between 120/80 and 139/89) may benefit from lowering of blood pressure with lifestyle modification and possibly medication, especially if there are other risk factors for end-organ damage such as diabetes or kidney disease (lifestyle changes are discussed below).
For some people, blood pressure readings lower than 140/90 may be a more appropriate normal cut-off level. For example, in certain situations, such as in patients with long duration (chronic) kidney diseases that spill (lose) protein into the urine (proteinuria), the blood pressure is ideally kept at 130/80, or even lower. The purpose of reducing the blood pressure to this level in these patients is to slow the progression of kidney damage. Patients with diabetes (diabetes mellitus) may also benefit from blood pressure that is maintained at a level lower than 130/80. In addition, African Americans, who have an increased risk for developing the complications of hypertension, may decrease this risk by reducing their systolic blood pressure to less than 135 and their diastolic blood pressure to 80 or less.
In line with the thinking that the risk of end-organ damage from high blood pressure represents a continuum, statistical analysis reveals that beginning at a blood pressure of 115/75 the risk of cardiovascular disease doubles with each increase in blood pressure of 20/10. This type of analysis has led to an ongoing "rethinking" in regard to who should be treated for hypertension, and what the goals of treatment should be.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: What are the signs and symptoms of high blood pressure? High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
What are the signs and symptoms of high blood pressure?
Comment on this Read 34 Comments Share Your Story
Uncomplicated high blood pressure usually occurs without any symptoms (silently) and so hypertension has been labeled "the silent killer." It is called this because the disease can progress to finally develop any one or more of the several potentially fatal complications such as heart attacks or strokes. Uncomplicated hypertension may be present and remain unnoticed for many years, or even decades. This happens because there are no symptoms, and those affected fail to undergo periodic blood pressure screening.
Some people with uncomplicated hypertension, however, may experience symptoms such as headache, dizziness, shortness of breath, and blurred vision usually with blood pressure that is very high. The presence of symptoms can be a good thing in that they can prompt people to consult a doctor for treatment and make them more compliant in taking their medications. Often, however, a person's first contact with a physician may be after significant damage to the body has occurred. In many cases, a person visits or is brought to the doctor or an emergency department with a heart attack, stroke, kidney failure, or impaired vision (due to damage to the back part of the retina). Greater public awareness and frequent blood pressure screening may help to identify patients with undiagnosed high blood pressure before significant complications have developed.
About one out of every 100 (1%) people with hypertension is diagnosed with severe high blood pressure (accelerated or malignant hypertension) at their first visit to the doctor. In these patients, the diastolic blood pressure (see the following section) exceeds 140 mm Hg! Affected persons often experience severe headache, nausea, visual symptoms, dizziness, and sometimes kidney failure. Malignant hypertension is a medical emergency and requires urgent treatment to prevent a stroke (brain damage).
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: What are the different types of high blood pressure? High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
Share this Article:
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
What are the different types of high blood pressure?
In addition to the most common type of hypertension in which both systolic and diastolic pressures are elevated, there are three additional types of high blood pressure (hypertension): isolated systolic high blood pressure, white coat high blood pressure, and borderline high blood pressure.
Isolated systolic high blood pressure
Remember that the systolic blood pressure is the top number in the blood pressure reading and represents the pressure in the arteries as the heart contracts and pumps blood into the arteries. A systolic blood pressure that is persistently higher than 140 mm Hg is usually considered elevated.
Isolated systolic hypertension is defined as a systolic pressure that is above 140 mm Hg with a diastolic pressure that is below 90. This disorder primarily affects older people and is characterized by an increased (wide) pulse pressure. The pulse pressure is the difference between the systolic and diastolic blood pressures. An elevation of the systolic pressure without an elevation of the diastolic pressure, as in isolated systolic hypertension, therefore increases the pulse pressure. Stiffening of the arteries contributes to this widening of the pulse pressure.
Once considered to be harmless, a high pulse pressure is now considered an important precursor or indicator of health problems and potential end-organ damage. Isolated systolic hypertension is associated with a two to four times increased future risk of an enlarged heart, a heart attack (myocardial infarction), a stroke (brain damage), and death from heart disease or a stroke. Clinical studies in patients with isolated systolic hypertension have indicated that a reduction in systolic blood pressure by at least 20 mm to a level below 160 mm Hg reduces these increased risks.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: White coat high blood pressure High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
White coat high blood pressure
A single elevated blood pressure reading in the doctor's office can be misleading because the elevation may be only temporary. It may be caused by a patient's anxiety related to the stress of the examination and fear that something will be wrong with his or her health. The initial visit to the physician's office is often the cause of an artificially high blood pressure that may disappear with repeated testing after rest and with follow-up visits and blood pressure checks. One out of four people that are thought to have mild hypertension actually may have normal blood pressure when they are outside the physician's office. An increase in blood pressure noted only in the doctor's office is called 'white coat hypertension.' The name suggests that the physician's white coat induces the patient's anxiety and a brief increase in blood pressure. A diagnosis of white coat hypertension might imply that it is not a clinically important or dangerous finding.
However, caution is warranted in assessing white coat hypertension. An elevated blood pressure brought on by the stress and anxiety of a visit to the doctor may not necessarily always be a harmless finding since other stresses in a patient's life may also cause elevations in the blood pressure that are not ordinarily being measured. Monitoring blood pressure at home by blood pressure cuff or continuous monitoring equipment or at a pharmacy can help estimate the frequency and consistency of higher blood pressure readings. Additionally, conducting appropriate tests to search for any complications of hypertension can help evaluate the significance of variable blood pressure readings.
Borderline high blood pressure
Borderline hypertension is defined as mildly elevated blood pressure higher than 140/90 mm Hg sometimes, and lower than that at other times. As in the case of white coat hypertension, patients with borderline hypertension need to have their blood pressure taken on several occasions and their end-organ damage assessed in order to establish whether their hypertension is significant.
People with borderline hypertension may have a tendency as they get older to develop more sustained or higher elevations of blood pressure. They have a modestly increased risk of developing heart-related (cardiovascular) disease. Therefore, even if the hypertension does not appear to be significant initially, people with borderline hypertension should have continuing follow-up of their blood pressure and monitoring for the complications of hypertension.
If, during the follow-up of a patient with borderline hypertension, the blood pressure becomes persistently higher than 140/ 90 mm Hg, an antihypertensive medication is usually started. Even if the diastolic pressure remains at a borderline level (usually less than 90 mm Hg, yet persistently above 85) treatment may be started in certain circumstances.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: What causes high blood pressure?
High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
Share this Article:
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
What causes high blood pressure?
Comment on this Share Your Story
Two forms of high blood pressure have been described -- essential (or primary) hypertension and secondary hypertension. Essential hypertension is a far more common condition and accounts for 95% of hypertension. The cause of essential hypertension is multifactorial, that is, there are several factors whose combined effects produce hypertension. In secondary hypertension, which accounts for 5% of hypertension, the high blood pressure is secondary to (caused by) a specific abnormality in one of the organs or systems of the body. (Secondary hypertension is discussed further in a separate section later.)
Essential hypertension affects approximately 72 million Americans, yet its basic causes or underlying defects are not always known. Nevertheless, certain associations have been recognized in people with essential hypertension. For example, essential hypertension develops only in groups or societies that have a fairly high intake of salt, exceeding 5.8 grams daily. Salt intake may be a particularly important factor in relation to essential hypertension in several situations, and excess salt may be involved in the hypertension that is associated with advancing age, African American background, obesity, hereditary (genetic) susceptibility, and kidney failure (renal insufficiency). The Institute of Medicine of the National Academies recommends healthy 19 to 50-year-old adults consume only 3.8 grams of salt to replace the average amount lost daily through perspiration and to achieve a diet that provides sufficient amounts of other essential nutrients.
Genetic factors are thought to play a prominent role in the development of essential hypertension. However, the genes for hypertension have not yet been identified. (Genes are tiny portions of chromosomes that produce the proteins that determine the characteristics of individuals.) The current research in this area is focused on the genetic factors that affect the renin-angiotensin-aldosterone system. This system helps to regulate blood pressure by controlling salt balance and the tone (state of elasticity) of the arteries.
Approximately 30% of cases of essential hypertension are attributable to genetic factors. For example, in the United States, the incidence of high blood pressure is greater among African Americans than among Caucasians or Asians. Also, in individuals who have one or two parents with hypertension, high blood pressure is twice as common as in the general population. Rarely, certain unusual genetic disorders affecting the hormones of the adrenal glands may lead to hypertension. (These identified genetic disorders are considered secondary hypertension.)
The vast majority of patients with essential hypertension have in common a particular abnormality of the arteries: an increased resistance (stiffness or lack of elasticity) in the tiny arteries that are most distant from the heart (peripheral arteries or arterioles). The arterioles supply oxygen-containing blood and nutrients to all of the tissues of the body. The arterioles are connected by capillaries in the tissues to the veins (the venous system), which returns the blood to the heart and lungs. Just what makes the peripheral arteries become stiff is not known. Yet, this increased peripheral arteriolar stiffness is present in those individuals whose essential hypertension is associated with genetic factors, obesity, lack of exercise, overuse of salt, and aging. Inflammation also may play a role in hypertension since a predictor of the development of hypertension is the presence of an elevated C reactive protein level (a blood test marker of inflammation) in some individuals.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: The metabolic syndrome and obesity High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
Share this Article:
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
The metabolic syndrome and obesity
Genetic factors play a role in the constellation of findings that make up the "metabolic syndrome." Individuals with the metabolic syndrome have insulin resistance with a resulting tendency to have type 2 diabetes mellitus (noninsulin-dependent diabetes).
Obesity, especially associated with a marked increase in abdominal girth, leads to high blood sugar (hyperglycemia), elevated blood lipids (fats), vascular inflammation, endothelial dysfunction (abnormal reactivity of the blood vessels), and hypertension, which all lead to premature atherosclerotic vascular disease. The American Obesity Association states the risk of developing hypertension is five to six times greater in obese Americans, age 20 to 45, compared to nonobese individuals of the same age. The American Journal of Clinical Nutrition reported in 2005 that waist size was a better predictor of a person's blood pressure than body mass index (BMI). Men should strive for a waist size of 35 inches or under and women 33 inches or under. The epidemic of obesity in the United States contributes to hypertension in children, adolescents, and adults.
What are the causes of secondary high blood pressure?
As mentioned previously, 5% of people with hypertension have what is called secondary hypertension. This means that the hypertension in these individuals is secondary to (caused by) a specific disorder of a particular organ or blood vessel, such as the kidney, adrenal gland, or aortic artery.
Three types of secondary high blood pressure (hypertension) are discussed below: renal (kidney) hypertension, adrenal gland tumors, and coarctation of the aorta.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: Renal (kidney) hypertension
High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
Share this Article:
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
Renal (kidney) hypertension
Diseases of the kidneys can cause secondary hypertension. This type of secondary hypertension is called renal hypertension because it is caused by a problem in the kidneys. One important cause of renal hypertension is narrowing (stenosis) of the artery that supplies blood to the kidneys (renal artery). In younger individuals, usually women, the narrowing is caused by a thickening of the muscular wall of the arteries going to the kidney (fibromuscular hyperplasia). In older individuals, the narrowing generally is due to hard, fat-containing (atherosclerotic) plaques that are blocking the renal artery.
How does narrowing of the renal artery cause hypertension? First, the narrowed renal artery impairs the circulation of blood to the affected kidney. This deprivation of blood then stimulates the kidney to produce the hormones, renin and angiotensin. These hormones, along with aldosterone from the adrenal gland, cause a constriction and increased stiffness (resistance) in the peripheral arteries throughout the body, which results in high blood pressure.
Renal hypertension is usually first suspected when high blood pressure is found in a young individual or a new onset of high blood pressure is discovered in an older person. Screening for renal artery narrowing then may include renal isotope (radioactive) imaging, ultrasonographic (sound wave) imaging, or magnetic resonance imaging (MRI) of the renal arteries. The purpose of these tests is to determine whether there is a restricted blood flow to the kidney and whether angioplasty (removal of the restriction in the renal arteries) is likely to be beneficial. However, if the ultrasonic assessment indicates a high resistive index within the kidney (high resistance to blood flow), angioplasty may not improve the blood pressure because chronic damage in the kidney from long-standing hypertension already exists. If any of these tests are abnormal or the doctor's suspicion of renal artery narrowing is high enough, renal angiography (an X-ray study in which dye is injected into the renal artery) is done. Angiography is the ultimate test to actually visualize the narrowed renal artery.
A narrowing of the renal artery may be treated by balloon angioplasty. In this procedure, the physician threads a long narrow tube (catheter) into the renal artery. Once the catheter is there, the renal artery is widened by inflating a balloon at the end of the catheter and placing a permanent stent (a device that stretches the narrowing) in the artery at the site of the narrowing. This procedure usually results in an improved blood flow to the kidneys and lower blood pressure. Moreover, the procedure also preserves the function of the kidney that was partially deprived of its normal blood supply. Only rarely is surgery needed these days to open up the narrowing of the renal artery.
Any of the other types of chronic kidney disease that reduce the function of the kidneys can also cause hypertension due to hormonal disturbances and/or retention of salt.
It is important to remember that not only can kidney disease cause hypertension, but hypertension can also cause kidney disease. Therefore, all patients with high blood pressure should be evaluated for the presence of kidney disease so they can be treated appropriately.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: Adrenal gland tumors High Blood Pressure (cont.)

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Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
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In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
Adrenal gland tumors
Two rare types of tumors of the adrenal glands are less common, secondary causes of hypertension. The adrenal glands sit right on top of the kidneys. Both of these tumors produce excessive amounts of adrenal hormones that cause high blood pressure. These tumors can be diagnosed from blood tests, urine tests, and imaging studies of the adrenal glands. Surgery is often required to remove these tumors or the adrenal gland (adrenalectomy), which usually relieves the hypertension.
One of the types of adrenal tumors causes a condition that is called primary hyperaldosteronism because the tumor produces excessive amounts of the hormone aldosterone. In addition to the hypertension, this condition causes the loss of excessive amounts of potassium from the body into the urine, which results in a low level of potassium in the blood. Hyperaldosteronism is generally first suspected in a person with hypertension when low potassium is also found in the blood. (Also, certain rare genetic disorders affecting the hormones of the adrenal gland can cause secondary hypertension.)
The other type of adrenal tumor that can cause secondary hypertension is called a pheochromocytoma. This tumor produces excessive catecholamines, which include several adrenaline-related hormones. The diagnosis of a pheochromocytoma is suspected in individuals who have sudden and recurrent episodes of hypertension that are associated with flushing of the skin, rapid heart beating (palpitations), and sweating, in addition to the symptoms associated with high blood pressure.
Reviewed by Jay W. Marks, MD on 4/11/2012

Next: Coarctation of the aorta High Blood Pressure (cont.)

1. High Blood Pressure (Hypertension) Slideshow 2. Take the Salt Quiz! 3. Lowering Blood Pressure Exercise Tips Pictures
Medical Author:
John P. Cunha, DO, FACOEP
Medical Editor:
Jay W. Marks, MD
Share this Article:
Facebook Twitter Email Print
In this Article * High blood pressure facts * What is high blood pressure? * How is the blood pressure measured? * How is blood pressure defined? * What are the signs and symptoms of high blood pressure? * What are the different types of high blood pressure? * Isolated systolic high blood pressure * White coat high blood pressure * Borderline high blood pressure * What causes high blood pressure? * The metabolic syndrome and obesity * What are the causes of secondary high blood pressure? * Renal (kidney) hypertension * Adrenal gland tumors * Coarctation of the aorta * What is the treatment for high blood pressure? * High Blood Pressure (Hypertension) - Slideshow * Take the HBP Quiz * Lowering Blood Pressure Exercise Tips - Slideshow * Salt FAQs * Patient Comments: High Blood Pressure - Effective Treatments * Patient Comments: High Blood Pressure - Numbers * Patient Comments: High Blood Pressure - Symptoms * Find a local Internist in your town * High Blood Pressure Index
Coarctation of the aorta
Coarctation of the aorta is a rare hereditary disorder that is one of the most common causes of hypertension in children. This condition is characterized by a narrowing of a segment of the aorta, the main large artery coming from the heart. The aorta delivers blood to the arteries that supply all of the body's organs, including the kidneys.
The narrowed segment (coarctation) of the aorta generally occurs above the renal arteries, which causes a reduced blood flow to the kidneys. This lack of blood to the kidneys prompts the renin-angiotensin-aldosterone hormonal system to elevate the blood pressure. Treatment of the coarctation is usually the surgical correction of the narrowed segment of the aorta. Sometimes, balloon angioplasty (as described above for renal artery stenosis) can be used to widen (dilate) the coarctation of the aorta.
REFERENCES:

Reviewed by Robert J. Bryg. "Stress and High Blood Pressure." WebMD Medical Reference. 6 Mar. 2009. <http://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-easing-stress>.

Reviewed by Robert J. Bryg. "High Blood Pressure Prevention." WebMD Medical Reference. 6 Mar. 2009. <http://www.webmd.com/hypertension-high-blood-pressure/guide/preventing-high-blood-pressure>.

"Coenzyme Q-10." WebMD Vitamins & Supplements Center. 2009. <http://www.webmd.com/vitamins-supplements/ingredientmono-938-Coenzyme%20Q10%20%28COENZYME%20Q-10%29.aspx?activeIngredientId=938&activeIngredientName=Coenzyme%20Q10%20%28COENZYME%20Q-10%29>.

Previous contributing author: Dwight Makoff, MD.

Reviewed by Jay W. Marks, MD on 4/11/2012

Next: What is the treatment for high blood pressure? Patient Comments: High Blood Pressure - Effective Treatments

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Comment from: Fuming, 65-74 Female (Patient) Published: September 16
On several occasions, I was switched to generic blood pressure medicine by my insurance company and retirement fund. This led me to be hospitalized on a few occasions as the generic does not work for me. I politely wrote to them and explained my situation and enclosed letters to confirm this from my doctor. Health insurance is included in my retirement package, but I do have to pay for this, of course it is not the same as the working individual, but I do pay. Anyway, if I want and need the name brand, I have to pay the larger amount of the coverage, which is 80% not the 20% working people do. This puts a strain on what I have saved for and to live with from my retirement benefits. Since the FDA approved all these generic drugs, mine one of them, it is getting so that the insurance companies and retirement programs have a say-so in your health, not your doctor. I would like to know who gave them that right. Also, I now get my medicine from Canada simply because it is still cheaper for me to get the name brand from them than it is here. That's another thing I would like to know: Why is it cheaper there than here? Come on people, we ship it there then we have to buy it from them cheaper? There is something terribly wrong with this picture. Retired In Florida
Comment from: 45-54 Female (Patient) Published: May 07
I developed hypertension when pregnant with my son 13 years ago. It never went away after the birth. I have taken a number of drugs to control it. I have been on 50mg of Metoprolol XL and 20 mg of Lisinopril for a while now. Although there now is a national shortage of Metoprolol XL, so my doctor had to change me to 25 mg of Atenolol twice a day until Metoprolol is available again. All the changes of drugs have been made because of insurance formulary restrictions. As a pharmacist myself, this is very detrimental to staying compliant on one's drug therapy! I wish we had nationalized health care.
Related Medications: Metoprolol | Lisinopril | Atenolol
Comment from: tammyjo71, 35-44 Female Published: September 16
I have high blood pressure, and I am now taking three pills a day for it. Well, I was on two, but it was going up quite a bit to like 170/100, so my doctor put me on a third pill, which causes my ankles to swell all the time. And, I am trying to quit smoking and so far I am doing well with. I want people to know, if you are dizzy a lot, at times have red cheeks, feel tried a lot, your heart feels like it races at times, please get your blood pressure checked, these were my signs, but everyone is different. My doctors told me that with my blood pressure going up and up, my heart would like explode…matter of speech. We must control our blood pressure because it can lead to worse health problems.
Comment from: chioma, 25-34 Male (Patient) Published: August 26
I was diagnosed with myocardial infection. I was not admitted in the hospital was just checked and given some drugs. I thought I was OK and continued my life. When I was diagnosed with high blood pressure and on a CT scan it showed my heart was enlarged. The doctors said that I was not properly taken care of that was what led to this situation. They said I should have been taking blood pressure drugs since then and it wouldn't have gotten this way. They advised me that I take my drugs religiously and that the situation will improve. I am presently on 5mg Lisinopril everyday and 12.5mg Esidrix every other day. My BP is average on 128/76 mm/HG and I pray it stays that way.
Comment from: kitcha, 55-64 Male (Caregiver) Published: June 16
I have high blood pressure for over 20 years and high cholesterol for five years. High blood pressure was brought under control initially with beta blockers, calcium channel blockers, then ace inhibitors and others. Now in the month of May I had hypotension (very low blood pressure) 73/53 collapsed and admitted in emergency and recovered in a few hours with a blood pressure of 130/90 with normal saline infusion for over 18 hours. I had to stay in the hospital for 6 hours in the emergency and two days in the general ward. This happened because of concomitant intake of 20 mg Olemesartan, 450mg of Lithium, 300mg of Seroquel (Quetiapine), 500mg of Sodium Valproate (Valpro) this was due to shock and hypotension secondary to medications and interactions. Doctors told me not to take any antihypertensive yet his assistant doctor left a note to revise and take proper antihypertensive. I came to know I can take minimal dose of Lasik I need more appropriate information in this matter.
Related Medications: beta blockers | calcium channel blockers | ace inhibitors
Patient Comments: High Blood Pressure - Effective Treatments

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Comment from: rebecca, 55-64 Female (Patient) Published: May 07
I have had high blood pressure for about 10 years. I also have a genetic disorder that puts me at a higher risk for a stroke. So I am trying to keep both in control by relieving my high-stress life. I am looking into tai chi or bio-feedback to try to battle both.
Comment from: Glenda, 45-54 Female (Patient) Published: April 06
I just recently discovered that I was at risk when I became feeling unwell. I suggested to my doctor that I felt I may have a cardio problem happening and I was ignored as I was being treated for a respiratory infection. He did not even offer to take my blood pressure. He said I was too young and in too good of shape to have those worries. Well I went out and bought a cuff. Sure enough I was running anywhere from 188/140 to 164/134. I went back to the doctor got diagnosed and I am currently trying a beta to lower the blood pressure and to take the stress off of my heart. I am very tired still. Now I am going to demand some tests to determine if I have any damage. If your doctor ignores you, demand that your blood pressure be taken. It can save your life.
Comment from: Mick, 19-24 Female (Patient) Published: March 24
I was diagnosed with hypertension when I was 16. I started taking nifedipine as a maintenance medication when I was 18. Still, even with the medicine, I have symptoms of hypertension, so I tried to lower my sodium in a slow process and exercise every day. My blood pressure eventually became normal, and I now am asymptomatic as well.
Related Medications: nifedipine
Comment from: Israel, 45-54 Male (Patient) Published: June 16
I have been on nifedipine and a water tablet for my hypertension for some time. There seems to be no improvement. I get headaches and lately problems with constipation and some abdominal pains. Headaches are doubt related to the hypertension but the abdominal pains, I am not sure. Could they be the cause of elevated hypertension? The headaches tend to be around the eyes. They get tired and sore too early in the day. I wear glasses and have considered them to be part cause of the problem. What next can I do?
Comment from: m72, 35-44 Female (Patient) Published: March 25
I bought a treadmill and started running 22 minutes a day and I bought a really good vitamin that has brought my blood pressure down to normal range. My blood pressure was right on the edge of being high. I also start using Mrs. Dash in the place of salt. I hope this information will help.
Comment from: GUS ALLEN, 65-74 Male (Patient) Published: September 26
I have high blood pressure and have taken a lot of different medicines and I have found Minoxidil works best for me.
Related Medications: Minoxidil
Comment from: Moti, 55-64 Male (Patient) Published: September 25
I am 70 years old with basic high blood pressure/hypertension for the last five years. When I smoked two to three packs a day and had a few drinks every day, I did not have high blood pressure! When my doctor discovered my high blood pressure, a prosthetic aortic valve was inserted. That was five years ago. I have not even touched a cigarette since, but I do have two large drinks every evening. I walk four kilometers every day and remain physically and mentally active. I have had to change medicines almost every three to six months. I also take a water pill every other day to prevent my feet from swelling.
Published: June 06
I am suffering from essential hypertension since 37 years I have taken various treatments & combinations of drugs to control it. I have to check regularly observe discipline in food habits exercise regularly. I have no cholesterol or diabetes. Presently I take Valent Aten 100 in morning & Catapres with Aspirin 75 in the night. I develop resistance to drugs & have to have them changed from time to time. I have to measure pressure regularly. It is the spot check which catches pressure & I have to visit the doctor to have the drugs changed. Patient Comments: High Blood Pressure - Effective Treatments

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Published: June 02
The best treatment that has been effective for my high blood pressure is simply walking every other day. I began to feel great and more alert!
Comment from: Boomer, 55-64 Female (Patient) Published: August 21
Drinking a glass of beet juice (I actually drink red beet crystals in a glass of grapefruit juice) lowers my blood pressure to the same degree as taking two meds (Toprol and Hyzaar) prescribed by my doctor. It's more expensive, my insurance would pay for the meds and I have to pay for the red beet crystals; however, I feel better drinking the juice. It does not have the side effects of waking up in the morning with my heart pounding and I have better energy all day.
Comment from: Wendy, 45-54 Female (Patient) Published: July 07
I suffer from HBP, I have had had it for 16 1/2 years, in my case it is hereditary. It was noticed when I was pregnant with my son. I am on Atenolol tablets 2 a day which I take in the morning (50mg), and I take 2 Amlodipine ( 5mg) at night.
Related Medications: Amlodipine
Comment from: Dee, 45-54 Female (Patient) Published: July 07
I went to see my Doctor who told me to see her after 2 weeks as my pressure had gone up. When I went back to see her she told me to see her again after 2 weeks. Somehow I got busy but after 3 months I ended up in hospital with a stroke. Good enough I recovered and was put 2.5 mg aprinox and some cholesterol tablets. I have since stopped taking the cholesterol tablets, but I am still taking the hp tablets.
Comment from: 55-64 Female (Patient) Published: June 16
I have been treated for high blood pressure for 9 years. It has been climbing higher for about four years, (175/100 or higher). Recently my doctor doubled my lisinopril from 10mg to 20mg and added a diuretic (.25htc). My blood pressure has dropped to 98/60. Sometimes it will go up to 117/90. I am extremely tired.
Comment from: 55-64 Female (Patient) Published: June 16
I am 59 and have just noticed higher blood pressure readings of 139/84 to 159/95 after spending my entire life below 120/80.I am taking intrathecal morphine by implanted pump for 10 years and 60mg of cymbalta for 2 months. I have complex regional pain syndrome since 1995. My pump has 120micrograms of morphine sulfate and a much lesser amount of bibufercaine. I was an active athlete until 3 years ago when pain became too unbearable upon lasting exercise. I take Nexium 40mg at night. What is your recommendation regarding starting hypertension drug therapy? Most of the adults in my family have hypertension at age 53 to 54.
Comment from: 35-44 Female (Patient) Published: May 13
I was diagnosed with hypertension (170/110) at 43 years old. I have no other risk factors, low cholesterol and LDL-no diabetes. I was put on Micardis 40mg. I lost 35 pounds, became hypervigilant with salt (1500mg/day) and very rarely drink alcohol (red wine). My BP went down to 110/60. I have to watch, though when I am lazy about salt, or go out to dinner a little too much BP does go up. Oh well even if you do the right things you can't fight genetics! Take your medications and check your pressure regularly. Approach it intelligently and you can live a long life with hypertension.
Comment from: 65-74 Female (Patient) Published: April 09
My blood pressure started about 6 years ago when I was given an inhaler for a breathing problem. My body swelled up all over including my mouth, causing me to be unable to eat for several days. Since then I have taken enalapril everyday and it seems to work for me.
Related Medications: enalapril
Comment from: Veronica, 45-54 Female (Patient) Published: January 07
I'm 49 and my Hypertension is all stress related, so under Doctor supervision I've been taking Naturopathic medication (after consultations with Naturopath) with regular exercise, I've found most days it stays within normal limits. Please Note: I had terrible reaction to Micardis hence the Naturopath.
Patient Comments: High Blood Pressure - Effective Treatments

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Comment from: woraiur, 45-54 Male (Patient) Published: September 25
I had high blood pressure, and by taking garlic regularly and reducing my weight by 15 pounds, my blood pressure has dropped.
Related Medications: garlic

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Patient Comments: High Blood Pressure - Symptoms

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Comment from: Jen1809, 25-34 Female (Patient) Published: October 17
I feel pretty terrible all the time with a thumping headache and pulse in my head, I am exhausted all the time. When my father was my age he had a hemorrhage due to high blood pressure and both my brothers are on medications. Last week I had one of my 'turns' and my boss sent me to the doctor where they found my blood pressure to be 181/115. At the docs previously I had a diastolic of 99 yet no-one has ever put me on anything, I'm just left to get on with it, I'm really concerned. I'm in a medical profession and fully aware of what could happen to me!
Comment from: Patricia, 65-74 Female (Patient) Published: January 30
I went through a period of ill health when I felt over-loaded, particularly in the evening with a pounding pulse, which at times I could feel in my head. My systolic blood pressure would rise up and up to sometimes as high as 190. I was breathless on lying down and sometimes felt a fluid shift in my chest which caused palpitations. At other times I collapsed and was hypotensive. Eventually it was found I had an electrolyte problem due to a kidney condition and reducing my fluid intake has avoided extreme symptoms. I have only recently started on a calcium channel blocker.
Comment from: bus driver, 45-54 (Patient) Published: November 16
Pounding heartbeat. Pulse so hard I could hear it in my ears. It would last anywhere from 5 minutes to off and on all day. Exhausted me. My pulse was fine, just a very hard beat. BP ranged from 117/78 to 179/97. I could feel it when my pressure went up. I didn't feel depressed or any anxiety. Mostly when I was active. Just doing yard work would get it started then I had to sit down till it passed. I am now on lisinopril 10mg. for one week. It was all good till today, and it all came back again. Going back to the doctor probably have to increase dosage.
Related Medications: lisinopril
Published: August 04
I have incredible headaches. I had them for a while, but when I went to get a biannual checkup, I had to be admitted into the emergency room because my blood pressure (BP) was so high. The last visit to the doctor was for pink eye, but when they took my BP, the doctor was more concerned about my BP than my pink eye. She (the doctor) gave me BP pills, which I did not want to take but did anyway. Well, the headaches stop when I take the medicine, and I don't like that. I don't want to have to take medicine in order to feel better. I know that sounds ridiculous, but there it is. I don't want headaches either though. Now since I read this information, I know that my eyesight may also be affected. I'll keep reading and see how I can help myself without having to take pills.
Comment from: cmaneri, 13-18 Female (Patient) Published: June 23
My high blood pressure symptoms included dizziness, confusion, panic attacks and severe headaches.
Comment from: clive limerick, 35-44 Male (Patient) Published: February 01
I have recently had neurosurgery. I have been fitted with an ANS model 120 for neuropathic pain which goes down my neck shoulders into arms and fingers. This took place on December 30th 2010 during my stay in hospital the nurse told me to check with my local doctor about my blood pressure. I get bad pains in my eyes and also headaches sometimes. I also suddenly get blurred vision which means I can't read no matter how hard I try. I visited my doctor and had a full blood test s done. Kidneys, liver, prostate, blood cell count, hepatitis and others all clear, but my doctor wants me back next week as my blood pressure was high.
Patient Comments: High Blood Pressure - Symptoms

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Comment from: paulie, 45-54 Female (Patient) Published: January 25
I had started experiencing blurred vision and shortness of breath at first and now lately headaches and nausea. I noticed that I could be on the treadmill of 30 minutes and be fine but could not walk up one flight of stairs without feeling totally out of breath. I knew I needed to lose some weight but not that much and I eat healthy for the most part. I had been what they call high normal on a couple of doctor visits but it always seemed to go down. I had to go to the urgent care the other night and when they took my blood pressure it was 162/119 which was not good, they preformed an EKG to make sure I was not having any signs of a stroke, thank god I was not but they did tell me that my heart was pumping extremely high and so they ended up sending me home with some meds to lower both my blood pressure and my heart rate. This was very eye opening for me since I am only 47, I knew I was not feeling totally normal but thought it was just my allergies. Just goes to show you that you cannot diagnose yourself, go get checked.
Comment from: ironman, 55-64 Male (Patient) Published: January 10
My high blood pressure was brought to my attention by a venous occlusion in my right eye in August 2010. I am a 63 year old male in excellent condition with a resting pulse of 54 and a record of consistent workouts. However, my blood pressure has elevated to unmanageable levels since August 2010 with no real change in my life style. My doctor is still trying to find out the cause and a way to control it. I guess high blood pressure can strike at any time and without warning.
Comment from: gene mann, 45-54 Male Published: December 13
Headache, tight chest, pain behind the eyes, throbbing temples, dizziness, and blurry vision. I suddenly showed these symptoms in just the last two days. They are severe after physical activity. I worked out last week with no problem but now I feel like i`m having a stroke after just a short walk.
Comment from: Debby, 55-64 Female (Patient) Published: November 27
My blood pressure would always go up whenever I was in pain or at the doctor office, but it was determined that it shouldn't go up that high so I was put on medication. Now I'm feeling much calmer and taking better care of myself. Now I know the cause of racing pulse, headaches, and a hot feeling in my face was all because of high blood pressure. I keep track of it ... don't ignore it.
Comment from: Brad, 45-54 Female (Patient) Published: August 09
Extreme headache with nausea. Also tightness in chest and panic attacks. Blood pressure was 160/105. It started when I was in my late 20's. I was never overweight and always athletic, but did smoke at the time.
Comment from: agape, 45-54 Female (Patient) Published: October 20
When my blood pressure is high, I have dizziness, chest pain in front and back behind my right breast. I also have headache, dry mouth and I am unstable standing.
Comment from: Bill, 65-74 Male (Patient) Published: October 13
I had enormous swelling in the lower legs and great (15 lbs) weight gain over a period of two days.
Comment from: $urfgurl, 45-54 Female (Patient) Published: September 08
I woke up in the middle of the night and opened my eyes. The room was spinning. It happened all through the night. Went to the ER the next day where they told me my blood pressure was high.
Comment from: 25-34 Female (Patient) Published: April 05
When I was pregnant that was my first time to be diagnosed with high blood pressure. My legs and hands were swelling. Patient Comments: High Blood Pressure - Symptoms

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Comment from: Talounjuni, 25-34 Female (Patient) Published: March 16
I had high blood pressure when I was 30 weeks pregnant and my whole body was swollen.
Comment from: jakebarrett, 65-74 Female (Patient) Published: March 16
I have rhinitis and HBP. People with HBP are always cautioned against salt. I also had a hemorrhagic stroke three months ago.
Comment from: Busy mama, 45-54 Female (Patient) Published: November 07
I didn't know what was going on. I was dizzy. My vision was blurred and I was feeling like I couldn't get a big yawn in. When I went to emergency I thought the doctors going to think I'm crazy, wasting their time. They didn't, turns out my blood pressure was 212/180. Take yourself seriously. You will know if things don't feel right.
Comment from: smile :), 19-24 Female (Patient) Published: August 24
I didn't know I had high bp until I became pregnant. My partner and I were trying for 2 years. Unfortunately due to the high blood pressure I had a miscarriage at 4 weeks. After many ultrasounds, bp tests and blood tests, the doctor worked out it may be caused by kidney sterosis (narrowing of the kidney artery),after a stressful operation for that my bp is still high and I'm still on medication, only thing left is to change my lifestyle.
Comment from: Myself1957, 55-64 Female (Patient) Published: August 02
My high blood pressure symptoms were very little. A headache now and then. I seemed irritated easily and got angry and exploded more easily. But never thought it could or would be Hypertension. I usually run 130/80-90. Sometimes, 138/98 or 86. I try to eat less fat, I do not use salt. I exercise and I am still overweight. Can't take nothing to aid weight loss because it ALL ups heart rates and BP.
Comment from: Anastasie, 45-54 Female (Caregiver) Published: July 12
Because of my high blood pressure I woke up with a severe headache, nausea, I vomited, the symptoms increased with movement. I was extremely sensitive to sounds and movement around me.
Comment from: ariel, 55-64 Female (Patient) Published: June 27
In 2002 I was a healthy and active 51 year old woman. After my road accident, I was extremely disabled due to a head injury. I had a lot of pain and symptoms came out little by little since I suffered from a neurological injury. One of these symptoms was acute chest pain with tingling sensations that went down my arms to my fingers. I was misdiagnosed and did not receive any kind of therapy or help until 2005. Then, I was properly diagnosed with TBI (traumatic brain injury). In 2010, my doctor sent me for an agiogram to see if there was any heart blockage, but my heart was strong and there was no blockage. Finally, I switched doctors. My new doctor had me wear a blood pressure monitor for 24 hours. The results showed that my blood pressure soared when I was sleeping or resting during the day. She put me on Ramipril and I saw almost immediate results. I rarely have the chest pain and numbing sensations now and feel much better.
Related Medications: Ramipril
Comment from: Vivienne, 35-44 Female (Patient) Published: June 01
I am a 38 year old female. When I was pregnant I had severe edema and an extra beat in my heart rate. I was tired and short of breath. I could not walk for more than 400m. I slept with a continental pillow and two standard pillows so I could breathe easier. It felt like someone was sitting on my chest if I didn't use all the pillows. The doctor thought the hypertension was pregnancy induced. When I went for my post natal check up my BP was 156/98.The doctor was given a 5mg per day enalapril prescription. A month later I was feeling light headed and unsteady on my feet. I had sharp pains in my chest. My BP was 170/140.I was given 10 mg enalapril plus a hypotone. I am taking 10 mg enalapril and two hypotones in the morning and in the evening. I feel unbalanced when I don't take my medication.