Nephrosclerosis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Nephrosclerosis?
A nephrologist, a kidney doctor, is the specialist who treats nephrosclerosis and other long-term kidney problems, often together with a primary care doctor or a cardiologist, a heart doctor. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is nephrosclerosis?
Nephrosclerosis is kidney damage caused by long-term high blood pressure. Doctors often call it hypertensive nephrosclerosis.
Healthy kidneys filter about a half cup of blood every minute. They remove wastes and extra water to make urine.
Over time, high blood pressure can narrow and weaken blood vessels, including the ones in the kidneys. The narrowing reduces blood flow.
Damaged blood vessels in the kidneys may stop working well. Then the kidneys cannot remove all wastes and extra fluid from the body.
Extra fluid can raise blood pressure even more, which creates a dangerous cycle. This can cause more damage and lead to kidney failure. High blood pressure can be both a cause and a result of kidney disease.
Symptoms
Most people with high blood pressure do not have symptoms. Chronic kidney disease (CKD) usually causes the slow loss of kidney function over time. Early CKD also may not have symptoms. The loss of kidney function can be so slow that symptoms do not show up until the kidneys have almost stopped working.
As kidney disease gets worse, some people may have swelling, called edema. Edema happens when the kidneys cannot get rid of extra fluid and salt. It can occur in the legs, feet, and ankles, and less often in the hands or face.
Symptoms of advanced kidney disease can include:
- Loss of appetite, nausea, or vomiting.
- Drowsiness, feeling tired, or sleep problems.
- Headaches or trouble concentrating.
- Increased or decreased urination.
- Itching, numbness, dry skin, or darkened skin.
Causes and who gets it
High blood pressure is the second leading cause of kidney failure in the United States after diabetes. Diabetes and high blood pressure are the two most common causes of CKD and account for most cases.
Blood pressure tends to increase with age. High blood pressure also tends to run in families. It is more common in African American adults than in Caucasian, Hispanic, or Asian adults.
How doctors diagnose it
Doctors check for kidney disease with a blood test called GFR, which stands for glomerular filtration rate. It shows how well the kidneys filter the blood.
They also use a urine test for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged. If you have kidney disease, your doctor uses the same two tests to keep track of it.
Your doctor diagnoses high blood pressure if your readings are consistently higher than 130/80 when tested repeatedly in a health care office.
Treatment
The best way to slow or prevent kidney disease from high blood pressure is to lower your blood pressure. These steps include a combination of medicines and lifestyle changes, such as:
- Being physically active.
- Keeping a healthy weight.
- Quitting smoking.
- Managing stress.
- Following a healthy diet with less sodium (salt).
Medicines that lower blood pressure can also significantly slow the progression of kidney disease. Two types of blood pressure medicines, called ACE inhibitors and ARBs, may be effective in slowing kidney disease.
A doctor may add a diuretic, a medicine that helps the kidneys remove fluid from the blood.
The goal is to keep blood pressure at or below 130/80 mm Hg. Your doctor can tell you your own target.
Always talk to your doctor before taking any over-the-counter medicine, including vitamins, herbs, and supplements.
When to see a doctor
If you have kidney disease, talk with your doctor about your blood pressure goals and how often your blood pressure should be checked.
Call 911 right away if you have chest pain or discomfort lasting two minutes or more, trouble breathing, confusion, fainting, or sudden weakness, dizziness, or a change in vision. Also call 911 if you suddenly cannot speak.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can check your blood pressure, order kidney blood and urine tests, and help you keep up with follow-up care. They can also refer you to a kidney doctor when needed.
Common questions
Can high blood pressure harm the kidneys?
Yes. High blood pressure can narrow and weaken the blood vessels in the kidneys. It is the second leading cause of kidney failure in the United States after diabetes.
Does kidney damage from high blood pressure cause symptoms?
Often not at first. Early CKD may not have symptoms. As kidney disease gets worse, some people may have swelling, called edema.
Can lowering blood pressure protect the kidneys?
Yes, it can help. The best way to slow or prevent kidney disease from high blood pressure is to lower your blood pressure. Medicines that lower blood pressure can also significantly slow the progression of kidney disease.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. They can check your blood pressure, order kidney tests, and help you follow your treatment plan. They can refer you to a kidney doctor and stay involved in your care.
Sources
- NIDDK - High Blood Pressure & Kidney Disease
- MedlinePlus - Chronic kidney disease
- PubMed Central - Hypertensive Nephrosclerosis: Pathological Changes and Overlap with Diabetic Nephropathy
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
