Renal hypertension and renal pathology of renal damage

Renal Parenchymal Disease: Cause, Symptoms, Treatment

May occur in patients with malignant hypertension renal artery disease small renal glomerular lesions and tubulointerstitial lesions.
1, the main pathological changes in small renal artery lesions, including vascular endothelial damage and small artery involvement performance. The naked eye can see, there is no basis in patients with kidney disease, kidney size is often normal, visible under the sebum and film spotting congestion and renal medulla. Light microscopy showed small proliferative endarteritis, necrosis of small arteries and mucin-like changes in the small arteries of the typical performance is fibrinoid necrosis, intimal lipid deposition and transparent thrombosis. Vessel wall and surrounding neutrophil and mononuclear cell infiltration. Interlobular artery intima may have fibrin deposition, intimal hyperplasia associated with severe collagen fibers were concentric deposition, showing typical onion skin-like performance. Severe stenosis of the blood vessel disease that leads to complete occlusion of the vessel lumen and renal ischemia. Kidney arcuate arteries often no obvious lesions, or only in chronic hypertension.
2, the glomerular capillary loops glomerular lesions can occur periodically fibrinoid necrosis, capillary lumen thrombosis. Glomerular basement membrane and glomerular sclerosis ischemic shrinkage, may have focal mesangial cell proliferation, occasionally forming a crescent; renal cyst wall thickening.
3, tubulointerstitial renal tubular epithelial cell loss can occur, such as acute tubular necrosis regeneration lesions; may have varying degrees of renal tubular atrophy. Visible renal interstitial edema, inflammatory cell infiltration can. As the disease progresses, there may be different degrees of fibrosis.
4, primary malignant hypertension and renal parenchymal renal pathology at different points renal artery had severe damage is a common feature of the two, but because of the pathogenesis of different diseases, there are two different pathological features.
Renal artery disease: primary malignant hypertension small artery disease seen in the acute phase of endothelial cell degeneration, loss and endometrial edema, severe and visible intimal wall fibrinoid necrosis, thrombosis. Chronic phase endometrium was onion skin-like fibrous thickening, stenosis. Renal artery mainly small wall thickening, small artery hyaline degeneration.
Glomerular lesions: Primary malignant hypertension glomerular lesions mainly glomerular basement membrane (GBM) and ischemic ischemic shrinkage sclerosis, severe cases can occur periodically fibrinoid necrosis. Renal glomerular inflammatory lesions mainly glomerular injury, mesangial matrix increase or glomerular sclerosis, sometimes visible typical variety of glomerular pathology.

Between tubular and renal interstitial disease: acute renal tubular injury with diffuse primary malignant hypertension, and degeneration, atrophy and regeneration, renal interstitial edema, sometimes showing lymphoid and monocyte infiltration spotty. Compared with renal parenchymal renal tubules and interstitial chronic injury, namely tubular atrophy and spotty compensatory hypertrophy, renal interstitial multifocal lymphoid and mononuclear cell infiltration and fibrosis.