CHRONIC KIDNEY DISEASE

SODIUM AND
POTASSIUM ELIMINATION ERYTHROPOIET ACID BASE ACTIVATION PHOSPHATE
WATER
BALANCE OF IN BALANCE OF VITAMIN D ELIMINATIONN
BALANCE
NITROGENOUS PRODUCTION
WASTE

HYPERT
HYPERKALEMIA ANAEMIA SKELETAL
ENSION
BUFFERING
HYPOCALCEMIA
COAGULOPATHIES
INCREASED EDEMA
VASCULAR
VOLUME BLEEDING ACIDOSIS
HYPERPARATHY
UREMIA
ROIDISM

HEART PERICA
FAILURE RDITIS

SEXUAL
IMPAIRED SKIN GASTROINT NEUROLOGIC DYSFU
IMMUNE DISORDERS ESTINAL MANIFESTATI NCTION OSTEODYSTROPHIES
FUNCTION MANIFESTA ONS
INTRODUCTION

Hypertension, or high blood pressure is an important medical and public health problem.
There is a direct relationship between hypertension and cardiovascular disease. As BP
increases, so does the risk of myocardial infarction , heart failure, stroke and renal disease. It
is sometimes called the “silent killer” as because people who have it are often symptom free.
The prevalence of hypertension in India is 25 % in urban area and 10 % in rural
population. According to estimates there are nearly 31.5 million hypertensives in rural and 34
million in urban population.

DEFINITION
Hypertension is defined as a systolic blood pressure greater than 90 mm of hg based on an
average of two or more accurate blood pressure measurements taken during two or more
contacts with a health care provider.
_ Seventh Report of Joint National Committee on Prevention,Detection,
Evaluation and treatment of High Blood Pressure ( UNITED STATES)

CLASSIFICATION OF HYPERTENSION ACCORDING TO NATIONAL HEART,

LUNG AND BLOOD INSTITUTE, UNITED STATES

CLASSIFICATION OF BLOOD PRESSURE FOR ADULTS AGE 18 AND OLDER

BP classification Systolic BP Diastolic BP

( mm hg) ( mm hg)
Normal < 120 < 80

Prehypertension 120-139 80 - 89
Stage 1 hypertension 140 - 159 90 - 99
Stage 2 hypertension Greater than or equal to 160 Greater than or equal
to 100

ETIOLOGY
Hypertension can be classified as either primary or secondary.

PRIMARY HYPERTENSION (ESSENTIAL OR IDIOPATHIC)

Hypertension is elevated BP without an identified cause, and it accounts for 90% to 95% of
all cases of hypertension. Although the exact cause of primary hypertension is unknown,
there are several contributing factors. These include –
 Increased Sympathetic Nervous System Activity
 Overproduction of sodium retaining hormones