Results at Tam Anh District 7 General Clinic showed Ms. Tuyet's blood creatinine level had reached 171 µmol/L (the normal range is approximately 44-97 µmol/L for women). According to Doctor Ho Tan Thong, from the Nephrology - Dialysis Unit, this elevated level indicates impaired kidney function. Ms. Tuyet's condition was an acute kidney injury episode superimposed on chronic kidney disease, triggered by a sudden spike in blood pressure that caused severe constriction of blood vessels leading to the kidneys, a protective response. This lack of blood supply impairs the kidneys' ability to filter, leading to a decline in function. Without proper treatment, this can lead to stage 4 kidney failure and rapid progression to end-stage renal disease.

Hypertension is the leading cause of kidney failure. At Tam Anh General Hospital, about 35% of patients seeking treatment for kidney failure are diagnosed with hypertension as the underlying cause. Doctor Thong explained that hypertension and kidney failure are closely linked. Prolonged high blood pressure damages and hardens the small blood vessels in the kidneys, reducing blood and oxygen supply to the organs. Consequently, the kidneys' filtering function gradually deteriorates, leading to chronic kidney disease.

When kidney function is impaired, the body retains water and salt, while also activating vasoconstrictive hormones, causing blood pressure to rise further and become more difficult to control. This creates a vicious cycle that significantly impacts the patient's health.

Ms. Huong's follow-up visit with Doctor Thong after two weeks of medical treatment. *Photo: Tam Anh District 7 General Clinic*

Doctor Thong noted that kidney failure stemming from hypertension often progresses silently in its early stages, making it difficult to detect. When patients exhibit symptoms such as uncontrolled blood pressure despite medication, along with swelling in the legs, ankles, and feet, frequent urination, fatigue, or shortness of breath, the disease has already advanced. Without proper treatment, this can lead to end-stage renal disease, stroke, myocardial infarction, and heart failure.

In patients with chronic kidney disease, a decline in kidney function due to infection, dehydration, or a hypertensive emergency can cause a sudden surge in blood pressure, triggering an acute exacerbation of chronic kidney disease, which may lead to acute pulmonary edema and become life-threatening.

Ms. Tuyet was prescribed medication to control blood pressure and received intravenous fluids to promote vasodilation, increase circulatory volume, and eliminate toxins and residual medications, thereby aiding kidney recovery. After 14 days of treatment, her blood pressure stabilized, and her blood creatinine level decreased to 104 µmol/L.

Ms. Tuyet needs continued health monitoring because her kidneys, having been previously damaged, are highly sensitive to future blood pressure spikes or medications that could affect renal function. She should follow a low-sodium diet to prevent fluid retention and blood pressure increases, and attend regular follow-ups so her doctor can adjust medication appropriate for her kidneys' current state.

To prevent kidney damage, Doctor Thong advises individuals with hypertension to undergo regular check-ups every three to six months to monitor kidney function. Early detection and intervention through medication, nutrition, and lifestyle changes can preserve kidney function for many years.

Dinh Lam

*Character names in the article have been changed*