Managing high blood pressure with chronic kidney disease stages 1-4

Learn how to manage high blood pressure if you have chronic kidney disease (CKD). Get tips on healthy eating, staying active, and medicines to protect your kidneys.

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March 26, 2025
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3 minutes

More than half of people with chronic kidney disease (CKD) also have high blood pressure. High blood pressure can cause CKD, and CKD can also cause high blood pressure. No matter the cause, high blood pressure can damage your kidneys, heart, and blood vessels, so it’s important to keep it under control.

What is high blood pressure?

Blood pressure is the force of blood pushing against your blood vessel walls as your heart pumps blood through your body. High blood pressure, also known as hypertension, occurs when this force becomes too high. Untreated high blood pressure can lead to heart attacks, strokes, heart failure, and faster progression of kidney disease.

High blood pressure and your kidneys

Over time high blood pressure damages your blood vessels and reduces blood supply to your organs, including your kidneys. This causes your kidneys not to function as well and makes it hard for them to remove waste and extra fluid from your blood.

Checking your blood pressure

Blood pressure is checked by using an arm blood pressure cuff. It should be checked every time you visit your care team. Your care team might also recommend checking your blood pressure at home and keeping a daily record.

Choosing the right blood pressure cuff

If you check your blood pressure at home, make sure you have an arm blood pressure cuff. Cuffs that go around the wrist, finger, or other sites are not accurate.

Arm blood pressure cuffs come in different sizes. It is important to get the right size cuff for accurate readings. You can figure out your cuff size by measuring your upper arm. Wrap a tape measure around at the midpoint and compare that number to a blood pressure cuff size chart.

Managing high blood pressure

There are many steps you can take to manage your blood pressure including:

  • Eating a healthy diet
    Following a diet that is low in sodium and rich in wholesome foods such as fruits and vegetables can help lower blood pressure. Your team can help you create a nutrition plan to help with your blood pressure goals.
  • Exercising regularly
    Adding regular physical activity can help you lower your blood pressure and maintain a healthy weight. Talk to your care team before starting an exercise routine.
  • Stopping smoking if you’re a smoker
    Smoking and using tobacco products can increase your blood pressure. If you need help quitting, talk to your care team to get the support you need.
  • Maintaining a healthy weight
    Your care team can help you determine your ideal weight. Losing weight if needed can help lower your blood pressure.
  • Managing other health conditions
    Managing other health concerns like diabetes and high cholesterol can help lower your risk for heart disease. A healthy lifestyle and taking your prescribed medications can help you manage these conditions.
  • Avoiding or limiting alcohol
    Talk to your care team about ways to reduce your alcohol intake. Current recommendations are that women should have no more than one drink per day and men should have no more than two drinks per day.

Medications for high blood pressure

You may be prescribed medications to help you reach your target blood pressure. The most common classes of blood pressure medications include:

  • Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs)
  • Diuretics
  • Calcium-channel blockers

Your healthcare provider may also prescribe beta blockers, aldosterone antagonists, alpha blockers, centrally acting alpha-agonists, and vasodilators. Ask your care team if you’re not sure if you’re on blood pressure medications or which ones you are taking.

Since high blood pressure usually causes no symptoms, it’s important to take your blood pressure medications exactly as prescribed, even if you are feeling fine.

Talk to your care team or healthcare provider before taking any medications, including over-the-counter medications. Some medicines, such as phenylephrine and pseudoephedrine for cold and flu symptoms, can raise blood pressure.

We are here to help

Your care team can help answer your questions about managing your blood pressure. Reach out for any support you need.

This serves only as a guide. Talk with your healthcare provider for more information based on your health needs.