benign hypertensive arteriosclerosis
Introduction
Introduction to benign hypertensive small arteriosclerosis Benign hypertensive small arterial nephrosclerosis is a disease usually associated with chronic hypertension that is characterized by involvement of blood vessels, glomeruli, and tubulointerstitial. The characteristic clinical manifestations of chronic hypertension are often accompanied by retinopathy, left ventricular hypertrophy, a relatively normal urine analysis, renal shrinkage and chronic progressive renal insufficiency with an increase in proteinuria (typically non-renal) suggestive diagnosis. Some cases may rule out other possible diagnoses: hypertension precedes proteinuria or renal failure, and there are no other obvious causes of kidney disease. Kidney biopsy can help establish a correct diagnosis, but it is rarely necessary. basic knowledge The proportion of illness: 0.002%-0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: high blood pressure
Cause
The cause of benign hypertensive small arteriosclerosis
High blood pressure (30%):
Renal sclerosis occurs with age, but can be aggravated by chronic hypertension. Patients with chronic hypertension have a lower overall incidence of progressive kidney disease. Most patients have mild hypertension. However, three factors increase. Risk of kidney cirrhosis: black race, moderate to severe hypertension and other existing kidney diseases (such as diabetic nephropathy).
Two processes contribute to the occurrence of vascular damage in chronic hypertension: middle layer hypertrophy and fibroblastic intimal thickening cause vascular lumen stenosis; secondly, glassy substance (plasma protein component) is deposited in damaged, easily permeable small In the arterial wall, the most common and specific change is the severe involvement of the small arterioles with glassy changes, degeneration of the inner elastic membrane and basement membrane, and fibrin-like necrosis of the entire blood vessel. The inner elastic layer is often damaged and possibly Layered.
Focal spherical sclerosis (30%):
The glomeruli may be characterized by focal spheroidal and focal segmental sclerosis. Focal sclerosis is due to ischemic injury and loss of nephron function, while focal segmental sclerosis is due to glomerular enlargement. It may be a compensatory response to loss of nephrons, vascular and glomerular involvement and frequent severe interstitial nephritis associated with ischemia and active immune processes due to altered expression of surface antigens on tubular epithelial cells.
Prevention
Benign hypertensive small arteriosclerosis prevention
1. Exercise: Strengthen physical exercise, increase the body's resistance, pay attention to the combination of work and rest, daily walks can be adhered to, self-not feeling fatigue, but also Qigong exercise, Tai Chi, do aerobics, to enhance physical fitness, Improve the body's resistance, prevent colds, and prevent the disease from aggravating due to respiratory infections.
2. Keep the urine smooth: the urine is smooth, indicating that the renal excretion function is normal. If the urethral obstruction occurs, the urine will not be smooth, it will increase the chance of inflammation of the renal pelvis and renal parenchyma, increase the burden on the kidney, and even cause urinary poisoning. Causes include urinary tract stones, enlarged prostate, tumors, and tuberculosis.
3. Pay attention to diet: pay attention to eating light and easy to digest food, avoid contraindications, let patients understand the importance and necessity of correct diet, avoid eating hard and cold food, overeating, over-eating fat, protect kidneys need to eat Protein and sugar, should not eat too high fat diet, too much fat in the diet, prone to renal arteriosclerosis, kidney atrophy, causing arteriosclerotic kidney disease, alkaline food is beneficial to the kidneys, can prevent urinary calculi Also, you can eat some winter melon, white thorn root, red bean, mung bean, etc., which is good for diuretic heat and protecting the kidneys.
4. Symptomatic care.
5. Leisure and work: Try to participate in social activities as little as possible. Once the patient is diagnosed with kidney disease, at the beginning stage, the rest should be based on active treatment and observation of changes in the condition. If the condition improves, the edema subsides and the blood pressure returns to normal or near normal. Urine protein, red blood cells and various tube types are small, and the kidney function is stable. After 3 months, you can start light work, avoid strong physical labor, and prevent respiratory and urinary tract infections.
6. Fertility and Sexual Life: For the sexual life problems of patients with kidney disease, traditional Chinese medicine has always advocated abstinence. The sexual life of patients with kidney disease depends on the specific circumstances. In principle, it does not advocate prohibition, and appropriate restoration of sexual life can help. In order to reverse the nervous system insufficiency and depression, especially in patients with kidney disease, due to the long course of disease, proper sex life can help the treatment of the disease. Of course, because of the physical exertion, the kidney disease patients are different. Normal people, before the condition has not recovered, must not cause the disease to increase, not excessive, otherwise, it is not worth the loss.
Complication
Complications of benign hypertensive small arteriosclerosis Complications
Nervous system, cardiovascular system, blood system and other clinical manifestations caused by elevated blood pressure, accompanied by severe hypertension and rapid renal failure.
Symptom
Benign hypertensive small arteriosclerosis symptoms common symptoms proteinuria hypertension renal failure kidney shrinking retinal hemorrhage
The characteristic clinical manifestations of chronic hypertension are often accompanied by retinopathy, left ventricular hypertrophy, a relatively normal urine analysis, renal shrinkage and chronic progressive renal insufficiency with an increase in proteinuria (typically non-renal) suggestive diagnosis. Some cases may rule out other possible diagnoses: hypertension precedes proteinuria or renal failure, and there are no other obvious causes of kidney disease. Kidney biopsy can help establish a correct diagnosis, but it is rarely necessary.
Examine
Examination of benign hypertensive small arteriosclerosis
Patients may exhibit a slow, progressive increase in urea nitrogen and plasma creatinine levels, hyperuricemia (not dependent on diuretic therapy), a relatively early finding that may reflect a reduction in renal blood flow caused by vascular disease, typical of urine analysis It appears as a small amount of cells or casts, and protein excretion is usually <1 g/d, but sometimes in patients with nephropathy, patients with significant proteinuria often have overlapping renal vascular disease.
Diagnosis
Diagnosis and diagnosis of benign hypertensive small arteriosclerosis
diagnosis
According to the medical history, clinical manifestations and laboratory data is not difficult to make a diagnosis.
Differential diagnosis
Should exclude all kinds of secondary hypertension, especially chronic nephritis hypertension, malignant renal arteriosclerosis, should also be differentiated from acute inflammatory nephritis systemic vasculitis.
