It’s called “the silent killer” because hypertension is often accompanied by few symptoms. At Princeton Hypertension-Nephrology Associates, patients with high blood pressure and kidney disorders are treated with the highest level of care, knowing one issue may be related to the other.

“A number of medical specialties care for patients with hypertension, but what has been found is the cause is often related to the kidneys,” said Grace B. Bialy, M.D., F.A.C.P.

In the United States, the average age of onset for high blood pressure is 32. Dr. Bialy explained there are several major types they see. The most common form is called “primary hypertension,” which means it is not clear why the patient develops high blood pressure. There is often a family history of high blood pressure and obesity, or high dietary salt intake can worsen it. Another form is “secondary hypertension,” which means that a specific and treatable cause can be identified. Some patients have so-called labile hypertension, in which the blood pressure fluctuates up and down.

“What we find is the most common secondary cause for high blood pressure is kidney disease,” Dr. Bialy added. “It could be a disorder of the arteries that supply oxygen and nutrients to the kidneys, or disease within the kidney tissue itself. Also, excess hormone production by the adrenal glands can lead to hypertension.

“Patients come to us and doctors refer to us because we are all designated as specialists in clinical hypertension by the American Society of Hypertension,” Dr. Bialy noted. “We are typically referred patients when their high blood pressure is difficult to treat.”

The physician-specialists at Princeton Hypertension-Nephrology Associates look at the whole patient as an individual. Hypertension frequently goes undiagnosed, and those who suffer from it for a decade or more will often have changes in blood vessels and kidney function that become permanent. These physicians see a large number of people with both high blood pressure and kidney disorders because they’re kidney specialists as well.

“There are many causes of kidney disease,” Dr. Bialy said. These include diabetes mellitus, hypertension, nephritis (inflammation in the kidneys), urinary blockages and genetic disorders such as polycystic kidney disease. Medications can also cause or worsen kidney impairment.

For kidney disorders, patients are referred when their doctors see their blood tests show abnormal kidney function or electrolyte levels. Simple urine tests may also reveal abnormalities that can help lead to a specific diagnosis. Unfortunately, many renal diseases are progressive in nature. However, careful monitoring and medication adjustment can often prevent or delay the need for dialysis or transplantation.

The American-trained and board-certified physicians at Princeton Hypertension-Nephrology Associates care for patients with many related serious disorders including acute kidney failure, heart failure and kidney disease (cardiorenal syndrome), electrolyte abnormalities and end stage kidney disease. Please call 609-750-7330 to schedule an appointment, and learn more at

Princeton Hypertension-Nephrology Associates, 88 Princeton-Hightstown Road, Suite 203, Princeton Junction. 609-750-7330.

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