Kidney failure – the root cause of high blood pressure in young people

High Blood Pressure in Young Adults Traced Back to Kidney Failure

Kiên, 29, assumed his elevated blood pressure was due to drinking too much coffee or work-related stress—until he was diagnosed with stage 3 chronic kidney disease.

A software engineer, Kiên often worked from morning until late at night, ate irregular meals, drank 2–3 cups of coffee daily to stay awake, and rarely exercised.

Earlier this year, he began experiencing mild headaches and dizziness. During a routine health check-up, his blood pressure was found to be high. Still, he reassured himself that it was just from sleep deprivation or job pressure. It wasn't until the symptoms worsened that Kiên decided to visit a hospital.

Doctors discovered his blood pressure had surged past 180 mmHg—well above the normal range of 90/60 mmHg to 129/84 mmHg. “I’m young—there’s no way I have high blood pressure. Maybe it’s just too much coffee,” he told the doctor.

However, further testing revealed that Kiên was in stage 3 chronic kidney disease. Dr. Đoàn Dư Mạnh of the Vietnam Vascular Disease Association explained that his creatinine levels were elevated and his kidney function had dropped to 40%, which was the primary cause of his high blood pressure.

Kiên’s case is not unique. Bình Dân Hospital in Ho Chi Minh City once treated a 23-year-old man with end-stage kidney disease—just two months after he was first diagnosed with hypertension. He had ignored treatment recommendations despite experiencing frequent headaches, dizziness, tongue numbness, and blurry vision. A month later, his blood pressure had climbed past 180 mmHg and occasionally peaked at 220 mmHg.

Although advised to be hospitalized for observation and further testing, he hesitated. Only when the headaches became unbearable did he check in. By then, the diagnosis was stage 5 kidney failure—end-stage renal disease—with severely diminished glomerular filtration function.

“This is an extremely unfortunate case,” said the attending physician. “Ignoring high blood pressure ultimately led to a lifetime of dialysis.”

A doctor examines and checks the blood pressure of a patient. Photo: Provided by the doctor

In Vietnam, chronic kidney disease is becoming an alarming public health issue, with over 10 million people affected—accounting for approximately 12.8% of the adult population. Each year, around 8,000 new cases are diagnosed, and an estimated 800,000 patients require dialysis treatment.

The trend of kidney disease affecting younger people is becoming increasingly evident. At the Nephrology Clinic of Binh Dan Hospital, doctors report that about one-third of patients are under 40 years old. In many cases, prolonged uncontrolled hypertension damages blood vessels, reduces blood flow to the kidneys, and destroys the glomerular filters, leading to kidney failure.

On the other hand, many young people suffer from hypertension with chronic kidney disease being the hidden underlying cause. According to doctors, the kidneys function like a miniature wastewater treatment plant. Each day, they filter around 180 liters of blood, removing waste, toxins, and excess water from the body via urine. When kidney function declines—meaning the “plant” is damaged or clogged—blood filtration becomes inefficient.

One of the kidneys’ essential roles is regulating the body’s sodium and water balance. When the kidneys are weakened, they can’t eliminate excess salt and water. Salt retains water, and this buildup increases blood volume. The higher the blood volume, the greater the pressure on blood vessel walls—similar to overfilling a hose—leading to high blood pressure, doctors explain.

In addition to filtering blood, the kidneys produce an important enzyme called renin. Renin is part of a complex system known as the Renin-Angiotensin-Aldosterone System (RAAS), which acts as the body's “blood pressure clock.”

When the kidneys detect low blood flow—often due to damage—they release renin. Renin initiates a chain of chemical reactions that ultimately produce a powerful substance called angiotensin II. Angiotensin II causes blood vessels throughout the body to constrict. Narrowed vessels force the heart to pump harder to circulate blood, leading to elevated blood pressure.

Angiotensin II also stimulates the adrenal glands to produce aldosterone, which tells the kidneys to retain more salt and water, further increasing blood volume and raising blood pressure. This creates a dangerous vicious cycle: kidney damage causes high blood pressure, and high blood pressure, in turn, causes more kidney damage.

Similarly, Dr. Le Thi Dan Thuy, Head of the Department of Nephrology and Dialysis at Binh Dan Hospital, confirms the close relationship between hypertension and kidney disease. “Prolonged hypertension can damage blood vessels, reduce blood flow to the kidneys, and impair glomerular function—raising the risk of kidney failure. Conversely, declining kidney function reduces the body’s ability to regulate blood pressure, which leads to hypertension,” Dr. Thuy explains.

A doctor at Binh Dan Hospital examines a 23-year-old man before dialysis. Photo: Tran Nhung

Experts believe that the increasing trend of hypertension and kidney failure among young people is largely due to unhealthy lifestyles, such as lack of physical activity, salty eating habits, preference for fast food and foods high in saturated fats, excessive alcohol consumption, smoking, and prolonged stress.

In particular, consuming too much salt, sodium-rich foods, and processed items (such as sausages and cold cuts) causes the body to retain more water, which increases blood volume and puts pressure on blood vessel walls, leading to high blood pressure.

The World Health Organization urges everyone to proactively check their blood pressure and monitor it regularly for early detection of hypertension. If high blood pressure is suspected, patients should undergo in-depth medical examinations to receive accurate diagnosis, appropriate treatment advice, and early screening for potential complications.

For prevention, it is recommended to exercise for at least 30 minutes daily, reduce salt intake (to under 5 grams/day, equivalent to about two teaspoons), consume more fruits and vegetables, limit alcohol, maintain a healthy weight, and absolutely avoid smoking.

“Making scientific lifestyle changes and proactively monitoring your health is the key to protecting your kidneys and preventing dangerous complications later on,” advised Dr. Manh.

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