Hypertension, renal hypertension symptoms also exists , not repeat them. Here
are just some of the special aspects of the performance of renal hypertension
make a profile .
Compared with the same level of essential hypertension, renal hypertension
essential hypertension compared with more progress to malignant hypertension ,
which occurs in approximately 2 -fold. Which , IgA nephropathy , especially
sclerosis , or hardening of IgA nephropathy secondary to malignant hypertension
, especially common. Also, comparison with primary malignant hypertension ,
renal parenchymal malignant hypertension worse prognosis , some authors
statistics , the former five-year kidney survival rate was 60%, while the latter
one and a half years renal survival is only 4 %.
Renal hypertension is often severe retinopathy , cardiovascular and
cerebrovascular complications occur more often . This is because in addition to
hypertension, other cardiovascular risk factors often compound the presence of
renal parenchymal disease, such as lipid metabolism disorder nephrotic syndrome
, and glucose metabolism during diabetic nephropathy , anemia, renal
insufficiency , and hyperuricemia disease, high homocysteine , uremic toxins,
metabolic acidosis , and micro- inflammatory state , these complex factors will
significantly increase the incidence of cardiovascular complications.
In this , the need to emphasize that especially affect renal hypertension and
chronic kidney disease on the basis of glomerular disease progression. Chronic
glomerular disease was before glomerular arterioles diastolic state, the system
is very easy to pass the glomerular hypertension , resulting in glomerular
hypertension, high perfusion and high filtration, this "three high " that can
accelerate the remaining glomerulosclerosis ; Meanwhile , long-term high blood
pressure can lead to kidney arteriosclerosis , including hyaline afferent
arterioles , interlobular artery and arcuate artery intimal thickening of the
muscle , so that small artery wall thickening luminal narrowing , secondary to
renal ischemia
Damage ( glomerular ischemic collapse was to ischemic sclerosis , tubular
atrophy and renal interstitial fibrosis ) . Therefore, renal hypertension is not
well controlled will significantly accelerate renal parenchymal disease
progression , creating a vicious cycle .
Urinary protein quantity glomerular disease , hypertension and kidney damage
effect is more obvious , because both effects overlay. Now known proteinuria,
especially in a large number of glomerular proteinuria can be caused by a high
pressure, high perfusion and high filtration promote glomerulosclerosis ; And,
filtered proteins ( including complement and growth factors , etc.) and in
combination with protein certain substances ( including lipid and iron, etc. )
after being tubular reabsorption , tubular cells can activate the release of
pathogenic factors ( such as transforming growth factor β , etc. ) to promote
renal interstitial fibrosis. Therefore, in patients with renal hypertension with
proteinuria , more should be strictly controlled hypertension.
The main points of renal hypertension diagnosis are: patients generally
younger ; previous history of kidney disease ; limbs often clammy , pale and
more ; higher diastolic blood pressure in a small pulse , blood pressure is
characterized by small fluctuations ; often nephropathy signs such as anemia,
hematuria , proteinuria , nocturia , renal varying degrees of damage ; B
ultrasound showed renal parenchyma diffuse lesions , such as renal cortical
thinning .
没有评论:
发表评论