Hypertensive Nephropathy (hypertensive nephrosclerosis or Hypertensive renal disease) is a kind of kidney disease, which is the consequence of chronic high blood pressure. Chronic high blood pressure causes damage to renal arterioles, eventually leading to nephrosclerosis. There are two types of this condition including benign nephrosclerosis and malignant nephrosclerosis. The latter rarely happens making up 1-5% of all patients. People of 40s to 50s with years’ history of high blood pressure are high-risk group of Hypertensive Nephropathy.
Chronic high blood pressure puts great strain on blood vessels. There are greater blood flows in kidney and heart than other organs. Over time, renal vessels would suffer damage---vessels begin to thicken and harden. The narrowing vessels couldn’t provide enough oxygen to tissues (ischemia) and tissues start to die from ischemia. Not only do the kidneys have trouble filtering blood quickly enough because of the reduced flow, but their function also declines because of the tissue death. Owing to kidney damage, some metabolic waste can’t excrete in daytime, so patient will have nocturia to discharge waste. With aggravation of condition, proteinuria follows on.
As mentioned above, frequent urination at night (nocturia), protein urine and hematuria are common symptoms of Hypertensive Nephropathy.
Frequent urination in the night
In Hypertensive Nephropathy, kidney tubules first suffer the influence of high blood pressure. As the reabsorption function of kidney tubules is damaged, patients need urinate frequently in the night.
Color change of urine
Hypertensive Nephropathy patient may find their urine turn dark, that is because the presence of red blood cells in urine.
If small bubbles present in urine and last for a long time, which signifies protein leaking in the urine.
In addition to kidney disease, Hypertensive Nephropathy patients also suffer other health problems, because high blood pressure is also hard on the heart and lung. Such patients may benefit from measures to reduce blood pressure, including diet and exercise as well as medications to force the pressure down.
ACEI and ARBs
ACEI and ARBs are recommended to Hypertensive Nephropathy patients, as these medicines can lower the blood pressure, and meanwhile they can reduce proteinurine so as to protect kidney function. What’s more, these medicines are also beneficial to vessels in heart reducing the risk of relating disease.
As patients’ disease get stable, micro-Chinese medicine can be use to alleviate the illness. Micro-Chinese medicine can reduce inflammation and dilate the vessels, so more blood could go through glomeruli. More waste can be filtered and glomeruli get oxygen and energy to recovery.
Dialysis or kidney transplantation
Hypertensive Nephropathy may progress to the point where the kidneys are no longer able to function well enough to support the lives of the patients. In these situations, dialysis or kidney transplantation may become necessary. Nephrologist could help patients choose the best treatment options considering patients own condition and side effect of treatment.
As the disease begins to progress, dietary changes often become necessary.
1. A low-protein and low-sodium diet is generally recommended as soon as the disease is diagnosed.
2. Potassium, magnesium, and phosphorous may need to be limited in later stages of the disease.
3. Fluid restrictions may be recommended as well when edema occurs. A kidney specialist or renal dietitian can be very helpful at assisting the patient in developing a healthy diet plan based on individual needs.
Symptoms of Hypertensive Nephropathy are minor, so the disease is always ignored by patients. Therefore, people with chronic high blood pressure should be cautious with these symptoms. Once these symptoms occur, patients should go to see a doctor to make sure your condition.
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