It’s a double-edged sword in kidney disease: hypertension can be both a cause and an effect. When high blood pressure is the result of kidney disease, it’s called renal hypertension. It develops when the kidneys are unable to properly regulate fluid balance and hormones that help control blood pressure.
If not adequately managed, hypertension can ultimately lead to serious health issues. Here’s how you can manage your blood pressure to lower your risk of kidney damage.
Protecting the Filters: The Importance of Nephron Preservation
Nephrons are microscopic parts of the kidney that are responsible for filtering out waste products from your blood, balancing levels of sodium and other electrolytes, managing blood pressure, and producing urine. They cannot be replaced if they are damaged or destroyed, so if you lose a large number of nephrons at any given time, that can lead to kidney failure.
Your body may try to compensate for nephron loss by using what is called hyperfiltration. While it works in the short term, it ultimately leads to more problems.
“We are born with a set number of nephrons, typically around a million, in each kidney,” says Marc Richards, MD, a nephrologist and the director of the Florida Kidney Physicians Glomerulonephritis Center of Excellence in Boca Raton. “When some of these nephrons burn out over time, because of aging, hypertension, diabetes, or any type of kidney disease, including C3G and IC-MPGN, remaining nephrons work harder to try and maintain ‘normal’ overall levels of filtration. In time, these nephrons burn out from working too hard, leading to proteinuria and subsequent nephron loss, and ultimately further progression of chronic kidney disease.”
New medications called complement inhibitors are advancing the treatment of C3G and IC-MPGN by addressing the underlying cause of the disease. But you also need to manage your blood pressure to protect the structure of the kidney from further damage. “Keeping blood pressures below target levels will help all patients with kidney disease, no matter the cause,” says Dr. Richards.
Medication for Blood Pressure Control
Medications to help control high blood pressure with C3G and IC-MPGN focus on the renin-angiotensin-aldosterone system (RAAS): a complex network of enzymes, proteins, and hormones that plays a crucial role in regulating blood pressure and volume.
If your blood pressure drops, this system tries to fix it by increasing the reabsorption of sodium and water from your kidneys into your bloodstream and narrowing the walls of the blood vessels in your kidneys.
An overactive RAAS system can lead to hypertension, as well as heart failure and chronic kidney disease. Medications including angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) interrupt this cycle.
RAAS blockers are essential for most people with C3G or IC-MPGN, and actually do "double duty," so to speak: lowering blood pressure while specifically reducing the internal pressure within the kidney’s filters.
“Overall blood pressure is reduced, but specifically these drugs dilate small arteries that drain the glomerulus, the tiny filtering mechanisms that produce urine from blood in each nephron,” says Richards. “This reduction of pressure inside the glomerulus has been shown to reduce protein excretion in the urine and prolong maintained kidney function.”
Lifestyle Strategies for Blood Pressure Control
In addition to medication, lifestyle measures including nutrition and exercise can help slow down kidney damage.
The Role of Sodium
“If you have kidney disease, salt affects you differently than it affects someone with healthy kidneys,” says Jen Hernandez, RDN, a registered dietician-nutritionist based in South Florida and founder of Plant-Powered Kidneys. “Healthy kidneys remove extra sodium from the body, but damaged kidneys cannot do this as well.”
When sodium builds up, your body holds onto extra fluid to try to lower the sodium concentration. That extra fluid raises blood pressure and can cause swelling. “Many people with chronic kidney disease are salt-sensitive, which means their blood pressure goes up more easily when they eat salty foods,” she says. “Lowering sodium intake can also help common blood pressure medications, like ACE inhibitors and ARBs, work better.”
The general recommendation from kidney disease experts is less than 2,300 milligrams (mg) of sodium per day or less than 2,000 mg if you have a history of fluid retention.
Reducing salt in your diet might seem complicated, but Hernandez points out practical steps that you can take:
Read food labels. Look at the sodium amount per serving. Try to choose foods with 140 mg or less per serving.
Limit processed foods. Packaged foods often contain a lot of sodium. “Salt added at the table with a salt shaker is usually not the biggest source,” says Hernandez.
Cook more at home. Using fresh, minimally processed ingredients gives you more control over how much salt goes into your meals.
Use other seasonings. You can build flavor without salt by using fresh herbs, garlic, lemon or lime juice, or spices such as paprika and cumin.
Fluid Management
One common symptom in C3G and IC-MPGN is swelling, which is caused when your kidneys cannot effectively remove excess fluid from your body. Too much sodium makes your body hold onto fluid.
“If you notice swelling in your legs, feet, or face, sodium restriction becomes even more important,” says Hernandez.
She recommends more steps to monitor and improve swelling:
Limit sodium to under 2,000 mg daily.
Check your blood pressure regularly.
Elevate your legs when sitting.
Avoid standing still for long periods.
Wear compression stockings if recommended.
Weigh yourself daily.
“Exercise helps lower blood pressure and protect your heart,” she says. “The general goal is 150 minutes per week of moderate activity, though your provider may recommend a different goal. If that feels overwhelming, start smaller. Any movement is better than none.”
Monitoring at Home
It’s important to keep track of your blood pressure, diet, and sodium intake. “Managing kidney disease takes consistency,” says Hernandez. “What’s important is building habits that can fit into your life in the easiest way possible. Even small reductions in sodium can improve blood pressure and reduce heart risk.”
She offers some ideas on how to make changes that will stick:
Keep a food diary. A food diary can help you spot high-sodium patterns. Some online food journals will even help point out your highest-sodium food preferences.
Use an app. There are apps that can be used to track sodium and blood pressure. Some offer both food journaling and vital sign tracking all in one.
Monitor blood pressure at home. Find a time in your day where you are most consistently available for just a few minutes.
Set small, realistic goals. “Remember that change doesn’t need to be drastic to be effective. Consistency is better than dramatic, random changes,” Hernandez says.
The Takeaway
Hypertension is an early clinical sign of C3G and IC-MPGN and often the first one noticed.
New complement inhibitor medications address the underlying cause of the disease, but blood pressure treatment is also necessary to protect the structure of the kidney.
A combination of medication and lifestyle measures can help keep blood pressure under control and prevent progression to kidney damage and kidney failure.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Moriconi D et al. Glomerular Hyperfiltration Predicts Kidney Function Decline and Mortality in Type 1 and Type 2 Diabetes: A 21-Year Longitudinal Study. Diabetes Care. February 14, 2023.
Martin K et al. Complement Inhibitors for the Treatment of C3G: The Dawn of a New Era. KidneyNewsOnline. January 8, 2025.
Renin-Angiotensin-Aldosterone System (RAAS). Cleveland Clinic. November 5, 2025.
Fountain JH et al. Physiology, Renin Angiotensin System. StatPearls. March 12, 2023.
Drawz PE et al. KDOQI US Commentary on the 2021 KDIGO Clinical Practice Guideline for the Management of Blood Pressure in CKD. American Journal of Kidney Diseases. March 2022.
Chung Yoon, MD, is a noninvasive cardiologist with a passion for diagnosis, prevention, intervention, and treatment of a wide range of heart and cardiovascular disorders. He enjoys clinical decision-making and providing patient care in both hospital and outpatient settings. He excels at analytical and decision-making skills and building connection and trust with patients and their families.
Roxanne Nelson is a registered nurse (RN) and a medical and health writer. Her work has been published by a range of outlets for both healthcare professionals and the general public, including Medscape, The Lancet, The Lancet Infectious Diseases, The Lancet Microbe, American Journal of Medical Genetics, American Journal of Nursing, Hematology Advisor, MDEdge, WebMD, National Geographic, Washington Post, Reuters Health, Scientific American, AARP publications, and a number of medical trade journals. She has also written continuing education programs for physicians, nurses, and other healthcare professionals.
She specializes in writing about oncology, infectious disease, maternal and newborn health, pediatric health, healthcare disparities, genetics, end of life, and healthcare cost and access. As an RN, she worked in newborn and pediatric intensive care, especially in settings with high rates of HIV infection and hepatitis B, and also in case management of NICU "graduates" who were now being cared for the home setting.
An avid traveler, Roxanne has explored the globe and stepped foot on all seven continents. Some of her travel had a medical and healthcare focus, while the rest was pure adventure. She lives in the Seattle metro area with her partner and two cats, although that number tends to change!
