Hypertension, or high blood pressure, is one of the most common chronic diseases affecting both the elderly and those of productive age. This condition often requires long-term, even lifelong, treatment. However, there is still a widespread belief that regularly taking hypertension medication can actually damage the kidneys and lead to kidney failure. Is this true?
As an internal medicine specialist, it is important to clarify this understanding so that patients do not misunderstand and stop much-needed treatment.
The Relationship Between Hypertension and the Kidneys
The kidneys play a vital role in filtering blood and regulating fluid balance and blood pressure. Long-term high blood pressure can damage the small blood vessels in the kidneys. This damage reduces the kidneys' ability to filter blood, which can eventually lead to chronic kidney disease and kidney failure.
In other words, uncontrolled hypertension is one of the main causes of kidney failure, not the cure.
Do Hypertension Medications Damage the Kidneys?
In general, prescription hypertension medications are safe for the kidneys and even play a role in protecting kidney function, especially when used according to medical advice.
Some important points that need to be understood include:
- ACE inhibitors and ARBs have protective effects on the kidneys, especially in patients with diabetes or early-stage chronic kidney disease.
- Mild elevations in creatinine early in treatment may occur and are often mistaken for kidney damage.
- These changes are generally temporary and indicate that the medication is working to reduce pressure in the kidney blood vessels.
With regular monitoring of kidney function, the use of hypertension medication remains safe and does not harm the kidneys.
So Why Do Some Hypertension Patients Experience Kidney Failure?
Misconceptions often arise because many hypertension patients are only diagnosed after their kidneys have already suffered damage. Hypertension is known as the "silent killer" because it often has no symptoms. As a result, patients seek treatment when their blood pressure has been high for years and organ damage, including the kidneys, has already occurred.
When patients start taking medication and then discover their kidney function is declining, the hypertension medication is often blamed. In fact, the kidney damage is due to long-term uncontrolled hypertension, not the medication.
The Risk of Kidney Failure Increases If the Medication is Stopped
Stopping hypertension medication without a doctor's advice can cause various serious risks, including:
- Blood pressure becomes uncontrolled again , thus accelerating kidney damage.
- Increases the risk of cardiovascular complications , such as stroke, heart attack, and heart failure.
Patients who do not comply with taking their hypertension medication have been shown to have a much greater risk of complications compared to patients who regularly take their medication and undergo regular health checks.
Drug Use Must Be Accompanied by Monitoring
Although safe, hypertension medication should still be used as directed by a doctor. Routine checks, such as blood pressure, kidney function (urea and creatinine), and blood electrolytes, are necessary, especially in elderly patients or those with underlying conditions such as diabetes.
Dosage or medication adjustments can be made if necessary. This is why regular check-ups and open communication between patients and doctors are crucial.
Other Factors That Can Trigger Kidney Damage
Apart from hypertension, there are several other factors that can accelerate kidney damage, including:
- Uncontrolled diabetes
- Excessive use of certain pain medications (NSAIDs)
- Not drinking enough water
- Recurrent kidney infections
- Unhealthy lifestyles such as smoking and excessive salt consumption
Often these factors are not recognized by patients and are actually associated with hypertension medication.
The belief that regularly taking hypertension medication causes kidney failure is a myth that needs to be debunked . On the contrary, hypertension medication plays a crucial role in protecting the kidneys from further damage caused by high blood pressure.
Kidney failure is more often caused by long-term uncontrolled hypertension, delayed diagnosis, and poor adherence to treatment. Therefore, patients with hypertension are advised to take their medication regularly, adopt a healthy lifestyle, and undergo regular check-ups as recommended by their doctor.
Article written by Dr. Fenny Elvina Ridho, Sp.PD – FINASIM (Internal Medicine Specialist, EMC Cikarang Hospital).