Hypertensive Kidney Disease refers to kidney damage caused by long-standing or poorly controlled high blood pressure, and it is one of the most common contributors to chronic kidney disease in the UAE. Persistent elevation of blood pressure places excessive strain on the delicate blood vessels within the kidneys, gradually impairing their ability to filter blood effectively and regulate fluid and electrolyte balance.

The kidneys play a central role in blood pressure regulation. When hypertension remains uncontrolled, it damages the renal arteries and arterioles, leading to thickening of vessel walls, reduced blood flow, and progressive scarring of kidney tissue. Over time, this process reduces functional nephron mass and accelerates decline in kidney function. Hypertensive kidney disease often coexists with diabetes, obesity, and cardiovascular disease, further compounding renal damage.

In the early stages, hypertensive kidney disease may be asymptomatic and detected only through abnormal laboratory findings such as elevated serum creatinine or protein in the urine. As the disease progresses, patients may develop worsening hypertension that becomes increasingly difficult to control, swelling of the legs, fatigue, reduced urine output, and symptoms related to declining kidney function.

Diagnosis is based on a combination of clinical history, blood pressure assessment, blood and urine tests, and imaging studies. Urine testing may reveal proteinuria, while blood tests demonstrate reduced kidney filtration capacity. Kidney ultrasound may show reduced kidney size in advanced disease, reflecting chronic scarring.

Management focuses on strict blood pressure control, which is the most effective strategy to slow disease progression. Kidney-protective antihypertensive medications are commonly used to reduce pressure within the kidney’s filtering units and limit further damage. Lifestyle modification, including dietary sodium restriction, weight management, physical activity, and smoking cessation, plays a critical role in treatment.

Regular nephrology follow-up allows close monitoring of kidney function, blood pressure trends, and complications such as anemia or electrolyte imbalance. Early and sustained blood pressure control can significantly delay progression to end-stage kidney disease.