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Hypertensive nephropathy

1.What is hypertensive nephropathy?
original hypertensive cause hypertensive nephropathy and make benign arteriolar nephrosclerosis and malignant arteriolar nephrosclerosis, and accompanied by the corresponding clinical manifestations of disease.
2What’s the pathogenesis of hypertensive nephropathy?
kidney is a organ than surround by blood capillary, it used to Filtering body endotoxin, prevent Proteins, blood cells and other substances leaking blood vessels. high blood pressure make the pressure of Intravascular blood increase, it cause protein leaking, if protein leaking can damage kidney strainer system, and lead to vicious circle, long time damage can’t be repaired, kidney Compensatory increase until failure. What’s the clinical manifestation of hypertensive nephropathy?
1) severe edema:
edema often is the first symptoms, it appear the whole body edema, if take finger press it has hollow, severe patients have hydrothorax, ascites. it may cause hard breath Umbilical hernia or inguinal hernia, height edema often appear less urine, high blood pressure, mild azotemia.
2)large number proteinuria
large number of proteinuria is the main symptom of nephrotic syndrome, urine prote often determine the nature is ++~++++,everyday adult urine protein discharge≥3.5g/d, most is selectivity proteinuria.
3) hypoproteinemia
plasma proteins reduce , serum albumin < 30 g/L, even less than 10 g/L
4) Hyperlipidemia
blood cholesterol and triglyceride are significantly increase
Patients’condition stages
In clinic, according to condition and test divide hypertensive nephropathy into several stages.
1) microalbuminuria: characterized by abnormal urine albumin excretion rate. Normal renal function, routine urine protein is negative.
2) clinical proteinuria: routine urine protein is positive, 24 h urinary protein quantitative > 0.5 g is the characteristics, normal renal function.
3) renal insufficiency: the characteristics is Ccr drop, SCr increase, divide into no dialysis period and dialysis period (uremia period).V 4) no dialysis period: Ccr is 40~10ml/min,133μmol/L < Scr < 707μmol/L
5) dialysis period (uremia period): Ccr < 10ml/min.Scr>707μmol/L
The treatment of hypertensive nephropathy
1.at early stage, mild hypertension and routine urine is near normal can take non-drug therapy, keep good emotion, lose weight, limit salt intake, quit drink, and take some exercise.
2. antihypertensive drugs
(1) diuretics;
(2) beta blockers;
(3) Calcium channel blockers;

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Xu Qing xuan. M.D.

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