How to distinguish hypertensive nephropathy and renal hypert

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How to distinguish hypertensive nephropathy and renal hypert

2017-11-07 17:27

Hypertensive nephropathy and renal hypertension often exist at the same time, the renal damage caused by hypertension is called hypertensive nephropathy, and secondary hypertension caused by renal disease is referred to as renal hypertension.If the medical history is clear, which is the first, then the performance is more typical, the two seem difficult to distinguish between, but the clinical situation is often complicated, need to be carefully identified.

renal damage caused by long-term chronic hypertension is often benign small arterial nephrosclerosis, the clinical first is due to tubulointerstitial ischemia caused by urinary enrichment dysfunction, increased nocturia in patients with urinary examination showed increased protein, and generally <2g / 24h. With the prolonged course of disease, the disease progressed slowly, the performance of glomerular filtration decreased, while the increase in urine protein is not obvious, generally not associated with hematuria. If there is hypertensive emergencies, malignant hypertension is associated with organ damage, kidney damage performance is generally referred to as malignant nephrosclerosis, including acute proteinuria, hematuria and renal failure. At this time of proteinuria is a large number, reaching the scope of nephrotic syndrome, hematuria is also gross hematuria, so you need to identify with glomerular diseases.

There are two kinds of renal hypertension, one is capacity-dependent, often due to renal failure, decreased urine output, effective lap capacity increased lead to increased vascular pressure caused. The other is non-capacity-dependent, because the renal tissue damage and / or functional damage, resulting in the body's blood vessels and vasoconstrictor material production and metabolism changes, and vasoconstrictor material dominant, leading to vasoconstriction, blood pressure Rise. So the general renal hypertension is accompanied by a marked decrease in urine volume or a severe pathological change in the kidneys.

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