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Thursday, Mar 13, 2008
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Online edition of India's National Newspaper Thursday, Mar 13, 2008 ePaper | Mobile/PDA Version |
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Tamil Nadu
IT is common knowledge that kidneys are a pair of bean shaped organs situated at the back of abdomen which carry out the all important function of excreting the water soluble waste products of protein metabolism (Urea and Creatinine). But it is not widely recognized that kidneys also are the chief regulators of Blood Pressure. They fine-tune the body’s fluid balance on a minute-to-minute basis so that the water and salt content of blood is kept within narrow limits. Whenever we lose excessive water and salt from the body in conditions such as diarrhea or vomiting, kidneys release certain vital hormones such as Renin and Angiotensin. These regulate the urine output and increase the salt reclamation in the kidneys, thereby preventing precipitous fall of Blood Pressure. Salt and Hypertension There is a strong link between the excess salt intake and high blood pressure in all major epidemiological studies done all over the World. In populations where salt consumption is low as in Yamomato Indians in South America, hypertension is not encountered. Man has taken to excess salt intake to tickle the taste buds in the tongue, but his kidneys are not ready to excrete the excess salt. The average salt consumption in our society is close to 15 grams a day, whereas the salt intake needed for health is only half of it. Our kidneys are not evolutionally engineered to excrete the excess of salt and hence there develops a slow and steady salt retention over years which bring about manifold bad effects by increasing the blood volume, sympathetic activity and contractility of blood vessels culminating in hypertension by the third to fourth decade of life. Thus kidneys are the villains as well as the victims in the drama of hypertension since over the years the high blood pressure damages its own nephrons. It is estimated that kidney failure develops in 30 % of people suffering from so called “Primary” or essential hypertension. In contrast Kidney disease per se due to immunological disorders (Glomerulonephritis) or renal artery blockage (Renal artery stenosis) can bring about “secondary” hypertension. It is crucial to differentiate these two situations. Clues to Renal hypertension The usual symptoms are, swelling in the body due to salt and water retention, Blood Pressure which is difficult to control, Blood Pressure requiring more than three different classes of drugs, excess excretion of Red Blood Corpuscles in urine, excess excretion of Protein in the urine, anemia without blood loss and high blood levels of urea and creatinine. If glomerulonephritis is suspected on the basis of tests, Kidney is biopsied to find out the exact pathology. If Reno vascular disease is suspected then special tests like radio – isotope study and CT/MRI scans are required. Dr. K. Sampathkumar, Head - Department of Nephrology Dr. T.R. Murali, Head - Department of Urology and Andrology Meenakshi Mission Hospital, Madurai.
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