How do blood pressure and diabetes damage the liver and kidney?
When the pressure exerted the blood on the wall of the arteries is higher than normal, it is called hypertension. Higher the blood pressure, greater is the risk of stroke, heart disease, kidney and liver problems. Hypertension may develop due to environmental, genetic, renal, vascular or endocrine causes.
Diabetes is a chronic multifactorial illness due to absolute or partial deficiency of insulin resulting in high blood sugar levels that affect the nerves and blood vessels of the body. Uncontrolled sugars can have adverse effects on the blood vessels of all the organs, especially the heart, brain, kidney, liver and eyes.
Diabetes and hypertension are closely interlinked similar risk factors such as vascular dysfunction and inflammation, arterial remodelling, atherosclerosis, dyslipidemia and obesity.
Common mechanisms that cause upregulation of the blood pressure maintenance systems, oxidative stress, inflammation and immune system activation contribute to the close relationship between diabetes and hypertension.
HOW THE KIDNEY IS DAMAGED
Persent uncontrolled high blood pressure can cause arteries supplying the kidneys to become narrow, weak and hard. These damaged arteries are then unable to deliver adequate blood to the tissue, there damaging the kidneys. The damaged kidneys cannot filter the impurities from the blood, resulting in loss of proteins and salts from the kidneys.
Similar mechanisms are seen in diabetes. A high blood sugar level blocks blood vessels and makes them narrow and leaky.
Diabetes damages the nerves of the urinary bladder, causing a loss of the sensation of fullness leading to urinary retention and increased back pressure on the kidneys. This also increases the risk of recurrent urinary infections (UTI). These factors slowly and progressively damage the kidneys.
WHY THE LIVER IS STRETCHED
Hypertension is a potential risk factor for liver injury and liver fibrosis. Elevated liver enzymes are seen in hypertension, especially ALT & GGT. High levels of fat in your liver (Fatty Liver) are also associated with an increased risk of diabetes, high blood pressure and kidney disease. The portal vein supplies the liver with blood. Over time, high blood pressure pushes collateral blood vessels to grow. These act as channels to divert the blood under high pressure. The extra pressure in these vessels causes them to dilate and stretch. A diseased liver causes portal hypertension and predisposes to cirrhosis. Hypertension and Non-alchoholic Fatty Liver Disease (NAFLD) have a bidirectional relationship. NAFLD causes hypertension a systemic inflammation, insulin resance, oxidative stress , vasoconstriction and gut dysbiosis.
The liver acts as the body’s glucose reservoir. Insulin resance and hyperinsulinemia are the pathophysiologic basis of diabetes in liver disease. Non-alcoholic fatty liver disease, alcoholic cirrhosis, chronic Hepatitis C (CHC) and hemochromatosis are more frequently associated with diabetes. Insulin resance, inflammation and oxidative stress lead to progression of fatty liver to cirrhosis.
