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Pathophysiology of Hypertensive Nephropathy

2012-10-17 11:16

Hypertensive Nephropathy refers to benign or malignant renal glomerular arterial sclerosis caused by long-term or chronic high blood pressure. In early disease course, the patients experience nocturia because of impaired renal tubules; later people may present slight to moderate proteinuria, edema, etc. As renal condition gets worsening, people are prone for other organ damage caused by hypertension, such as retinopathy, heart disease, etc.

Pathophysiology of Hypertensive Nephropathy

For people with hypertension, the incidence rate of hypertensive kidney damage is in positive correlation to the severity and duration of high blood pressure. Other risk factors for developing hypertensive nephropathy also include gender, race, Diabetes, hyperlipidemia and high uric acid. Males tend to have a higher incidence rate as composed to females. Usually, the onset of primary high blood pressure is at one’s 25-45 years old; while at 40-60 years old people may pose symptoms of renal damage caused by hypertension.

The kidneys surrounded by capillaries discharge toxins out of the body and prevent such substances as proteins and red blood cells from running away. High blood pressure can increase pressure within renal capillaries and cause proteins to leak out. The protein loss can destroy filtering system of the kidneys, thus causing a vicious cycle. If people experience nocturia, this suggests ischemic lesions in renal tubules and reduced urine concentration functions. However, the symptom may be ignored or misunderstood to be caused by another condition. Usually, proteinuria is +-++ and 24h urine protein is no more than 2g, but some may also have massive proteinuria.

Urinary sediment microscopic examination suggests slight red or casts, and some may experience intermittent hematuria due to ruptured glomerular capillaries. As is researched, about one in 10,000 cases people with primary high blood pressure may develop renal failure, and people whose hypertension is poorly treated experience faster deterioration in kidney functions. Involvement of other organ damages, especially cardiovascular complications, may come much earlier and severer than the kidneys, thus greatly affecting the prognosis of Hypertensive Nephropathy. Amongst heart complications common diseases include hypertensive left ventricular hypertrophy, coronary disease, angina and heart failure. In addition, primary high blood pressure can also cause retinal arterial sclerosis and result in retinal arterial sclerosing lesions. The extent of retinal sclerosis is often in parallel to sclerosising damage on renal arterials, so fundus examination is very important.

The above introduces the pathophysiology of Hypertensive Nephropathy. Hypertensive Nephropathy is one of the dangerous complications caused by chronic high blood pressure. People need to do early screening tests for the disease, and in case any of the mentioned signs appear, don't miss the earliest time to find out the disease and stop further progression.

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