Will Congenital PKD Cause High Blood Pressure

High blood pressure is one of the most common symptoms in the early stage of PKD. Among young PKD patients that have normal kidney functions, there are about half have blood pressure higher than 140/90mmHg and nearly all end stage PKD patients have high blood pressure. Blood pressure is proportional to that of kidney size and number of cysts and it will increase along with age.

High blood pressure is also one of the major worsening factors for PKD. Strict control of blood pressure can slow down the decline rate of kidney functions and reduce its mortality. The ideal value of blood pressure is 130/80mmHg.

In the early stage of high blood pressure, patients should limit salt intake (2-4g/d), maintain proper body weight and have regular physical exercises. Medicines for treating high blood pressure are ACEI, ARB and calcium channel blocker. If these medicines fail to control blood pressure, surgeries such as renal decortication, renal artery embolization and nephrectomy can be considered.

The continuous enlargement and increase of cysts in kidneys will oppress normal renal tissues and cause ischemia, hypoxia and hypoperfusion in the kidneys. If high blood pressure is not controlled well, it will worsen pathological damages---aggravate renal fibrosis, further increase creatinine. Worsening of kidney functions will in turn cause blood pressure to have further increase which can cause the heart enlargement and heart failure.

Different from that of primary hypertension, treatments for high blood pressure in PKD should focus on treating multiple cysts---reducing oppression to renal parenchyma, slowing down or blocking the process of renal fibrosis.

Is surgery the best treatment option for treating high blood pressure in PKD?

This depends on the patient’s illness and physical conditions. If the patient is in the end stage and hypertension is very severe, surgery can help alleviate the symptoms in short time and achieve quick effects. However if the patient is only in early stage and high blood pressure is not very severe, herbal medicines plus proper diets might be a good choice. Some herbs can expand renal arteries, improve systemic microcirculation so as to increase blood and oxygen supply to the kidneys. Active ingredients in herbal medicines can also increase permeability of the cyst wall and inactivate epithelia cells so as to inhibit continuous secretion of cystic fluid. When the cysts are shrunk and kidney functions are improved, blood pressure will be lowered.