Nephrosclerosis
Introduction
Introduction to nephrosclerosis Renal sclerosis includes arterial nephrosclerosis caused by renal atherosclerosis, and benign nephrosclerosis and malignant nephrosclerosis caused by hypertension. Renal atherosclerosis is part of systemic atherosclerosis and is more common in the elderly, with or without hypertension. The pathogenesis of arterial atherosclerosis is the same as that of other organs. basic knowledge The proportion of illness: 0.0003% Susceptible people: no special people Mode of infection: non-infectious Complications: Hypertension Uremia
Cause
Cause of nephrosclerosis
1, arterial nephrosclerosis: the pathogenesis is the same as the atherosclerosis of other organs.
2, benign renal sclerosis: hypertensive vasculopathy and glomerular hypertension can lead to glomerular injury, vascular and glomerular lesions of benign nephrosclerosis can also be seen in the elderly, even patients without hypertension, these changes may It is associated with a progressive decline in GFP in the elderly.
3. Malignant nephrosclerosis: The initial lesion is a damage to the vessel wall caused by a sharp rise in blood pressure.
Prevention
Kidney sclerosis prevention
(1) Diet should be eaten spicy and fat and sweet, into a low-salt diet, quit smoking, diet, and diet, usually with a light vitamin-rich diet.
(2) There must be regular life and daily life, and often participate in appropriate physical exercise, paying attention to work and rest.
(3) Dialectical protection to psychologically guide patients, so that they can build confidence in treatment, and teach patients some control emotions, adjust mentality, arrange a comfortable environment for patients, keep the room quiet, avoid noise and shake the bed frame, The light should not be too strong, the yin deficiency is the main, eat less ginger, mutton and other foods, eat more food and yin; yang deficiency pay attention to keep warm, eat less cold and cool.
Complication
Nephroscler complications Complications, hypertension, uremia
Renal arteriosclerosis, secondary to hypertension, can be divided into benign and malignant renal arteriosclerosis. The former has a longer course of disease, and the general course of disease is 20 years, but there are still a small number of patients in the course of illness (1%-8). %) to a malignant phase, if not treated in time, often died within 1-2 years, the latter lesions develop rapidly, renal function deteriorates sharply, and enters renal uremia in a short period of time, often accompanied by heart, brain and other multi-organ function decline, If the mortality rate is not more than 50% within 3 months, and 90% within 1 year, as long as early patient treatment, the key is to keep blood pressure in the normal range for a long time. Most patients have benign renal arteriosclerosis. After that is optimistic.
Symptom
Symptoms of nephrosclerosis Common symptoms Papillary edema palpitations, soreness, blood, urine, weight loss, shortness of breath
Patients with arterial atherosclerosis can show signs of systemic atherosclerosis, such as cardiac, brain and peripheral vascular sclerosis, with or without hypertension, and the benign phase of essential hypertension is overweight, headache, Dizziness, palpitations, shortness of breath, mental stress and pain in the anterior region, malignant stage manifestations of headache and hypertensive encephalopathy, weight loss, visual impairment, early kidney sclerotherapy, back pain, edema, hematuria, nocturia, etc. See the performance of renal failure.
Examine
Examination of nephrosclerosis
1, blood routine, urine routine.
Urine analysis: 1 proteinuria, 2 red blood cells: mainly seen in patients with malignant phase, gross hematuria in severe cases.
2, renal function test: patients with benign period, mild, moderate hypertension generally have no effect on renal function, more severe hypertension mostly reduced GFP to 65ml / min level, before the occurrence of renal insufficiency, hyperuricemia Symptoms may be an earlier manifestation of a decrease in renal blood flow caused by arterial and arteriolar lesions.
3. Kidney biopsy.
Diagnosis
Diagnosis and identification of nephrosclerosis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Differential diagnosis
1, renal vascular hypertension
Hypertension, but more common in young people, normal blood pressure in the past; upper abdomen can be heard vascular murmur; intravenous urography angiography two kidney long axis length difference of more than 1.5cm; renal artery angiography showed renal artery trunk stenosis and stenosis and expansion.
2, chronic pyelonephritis
It is characterized by chronic progressive hypertension and kidney shrinkage, but in the past there was a history of urinary tract infections, urinary system symptoms and urinary changes occurred before the occurrence of hypertension; the number of pus cells in the urine was high, and common bacteria cultured had pathogenic bacteria.
