• Effect of high blood pressure on kidneys: When blood pressure is elevated, it strains the blood vessels throughout the body, including those in the kidneys. Over time, high blood pressure damages and weakens the blood vessels, causing them to narrow and restricting blood flow.

• Effect of kidneys on high blood pressure: With reduced blood flow, the kidneys cannot effectively filter wastes and excess fluid. Fluids build up, leading to higher blood pressure and further damaging the blood vessels and kidneys. [4]

The good news is that this cycle can be broken with proper treatment. For people with CKD, the goals of treatment are to:

• Lower blood pressure below 130/80 mmHg
• Prevent further kidney damage
• Reduce the risk of heart disease [4]

To help achieve these goals, doctors may prescribe medications like:

• ACE inhibitors relax blood vessels and lower blood pressure.

• ARBs (like Diovan) widen blood vessels and reduce strain on kidneys.

• Beta-blockers slow heart rate and reduce blood pressure

• Diuretics flush out excess fluid and sodium, lowering blood pressure [2]

Heart Disease and CKD

Chronic kidney disease (CKD) and heart disease often go hand in hand. When you have CKD, you are more likely to develop heart disease. And if you have heart disease, it can lead to CKD. In fact, heart disease is the leading cause of death for people on dialysis. [5]

Heart disease refers to any issue with the heart or blood vessels that prevents the heart from pumping blood as efficiently as it should. It's also known as cardiovascular disease (CVD). [5]

If you have both CKD and heart disease, your doctor may prescribe certain medications to help control your heart condition, including:

• Diuretics (also called "water pills”) help your kidneys flush extra salt and water from your body by making you urinate more. Aldosterone receptor blockers are a type of diuretic used to treat congestive heart failure (CHF). They help your body get rid of excess fluid.

• ACE inhibitors: These medications lower blood pressure by relaxing your blood vessels. This allows your kidneys to eliminate extra water and reduces the levels of hormones that can raise your blood pressure.

• Beta-blockers: These drugs lower blood pressure by blocking the effects of adrenaline. This allows your heart to beat more slowly and with less force.

• Potassium binders remove excess potassium from the blood. When the kidneys aren't working properly, they can't eliminate enough potassium, which can cause heart and muscle problems. [2]

Anemia and CKD

Anemia is a common complication of chronic kidney disease. When your kidneys are damaged or diseased, they cannot produce enough of a hormone called erythropoietin that stimulates your body to make red blood cells. Red blood cells carry oxygen throughout your body, so you can feel exhausted and run down without enough of them. [2]

The good news is there are treatments for anemia from chronic kidney disease.

• Erythropoiesis-stimulating agent (ESA): These injections help boost your red blood cell production. ESA injections are effective at relieving anemia.

• Iron supplements: Iron is essential for your body to make new red blood cells. Without adequate iron stores, your ESA injections won't work as well. Iron supplements can be taken as pills, given intravenously through an injection, or even added to your dialysis treatments. [2]

Bone Disease and CKD

Bone disease is a common complication of chronic kidney disease (CKD). When CKD damages the kidneys, they cannot properly filter blood and regulate hormone levels. This leads to an imbalance of hormones and minerals like calcium and phosphorus, resulting in bone damage. [6]

There are a few ways that damaged kidneys contribute to bone disease:

• The kidneys stop converting vitamin D into its active form, known as calcitriol. This leads to improper calcium absorption and imbalance.

• The kidneys cannot adequately remove excess phosphorus from the blood. This triggers the blood to pull calcium from the bones, weakening them over time. [6]

The good news is that treatments are available to prevent further bone and blood vessel damage from CKD-related bone disease. These treatments focus on controlling mineral and hormone levels. Your doctor may prescribe:

• Phosphate binders: These medications bind to phosphorus in your digestive tract so that your body does not absorb it into your bloodstream. This helps lower high phosphorus levels in the blood that weaken your bones.

• Calcium and vitamin D supplements: Kidney disease often causes calcium and vitamin D deficiencies or excesses. Supplements help restore balance and promote bone health. [2]

Secondary Hyperparathyroidism and CKD

Secondary hyperparathyroidism is when the parathyroid glands overproduce the parathyroid hormone (PTH). This excessive PTH in the bloodstream can lead to complications such as: [2]