When a diagnostic statement lists hypertension and chronic kidney disease,?

When a diagnostic statement lists hypertension and chronic kidney disease,?which gets coded first?

I am going crazy trying to figure this.
I just want to know which should be coded first? The hypertension or the chronic kidney disease

Posted by Iranian Doctor
Well, this is vicious circle and in this hypertension will destroy the kidneys and then kidneys will eventually start loosing protein along with urea and ammonia which will cause multiple organ failure and fluid retention causing hypertension.

At this moment you need to check hypertension by the following means:
1. Use of calcium channel blocker such as Amlodepine.
2.Use of vaso dilators such as Omlesartan hydrochloride.
3.Reduction in excess fluid volume(if present due to edema) by the use of diuretics such as Lasiclactone or sprinilactone.

Now what is to be monitored and diagnosed clearly is that is it the kidney disease which is causing hypertension( like renal vessel constriction or low glomerolous filtration rate) or the hypertension damaging the kidneys(destroying the nephrons and renal vessels by hyper volume of fluid and high nephritic pressure).

What ever the cause is, must be isolated and then the prognosis done accordingly.

Hypertension is a silent killer, it will show only symptoms after it has done organ damage and all organs are at risk, since the general venous and osmotic pressure is high in the body.

Heart must be checked by echo cardiography and ECG, since hypertension destroys the heart first, it will stiffen the left ventricle and will cause hypertrophy in it leading to HOCM(hyper obstructive cardiomyopathy) and then heart failure.

If the kidney has developed its own disease then it should be diagnosed and controlled as suggested.

Another serious situation with hypertension and kidney disease is that it will damage the kidneys and as the kidneys are damaged, the nephrons will become more porous causing even the big protein molecules to pass through it along with micro molecules like ammonia and urea and will cause hypertension as fluid will remain in the body due to low protein volume in the blood and will cause hypertension.

At this moment, all things must be checked like 24 hour urine protein output test, cretanine levels in urine and blood, Albumin in blood and urine.

Ecocardigraphy and ECG for cardiac functions and Venous blood pressure monitoring.

Posted by Jeff O.
Karen,
Do U have Kidney Disease? I do. It's FSGS.

Know better? Leave your own answer in the comments! Learn basic information on kidney disease from the experts at Kidney Disease Info Blog.

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