How to pay attention to kidney damage in patients with hypertension?

  Hypertension is the most common cardiovascular disease in the world and one of the largest epidemics, seriously endangering human health. Hypertension can be diagnosed with blood pressure >= 140/90 mmHg measured on 2 or more non-same days with more than 5 minutes of rest.  Hypertension is capable of causing a variety of serious complications. Among the various complications of hypertension, the damage to the heart, brain and kidneys is the most significant. However, many people only recognize that hypertension can cause stroke and coronary heart disease, but ignore that hypertension can also cause kidney damage and even lead to the occurrence of uremia. Patients with hypertension usually only visit the cardiovascular department, but do not think of going to the nephrology department to check the urinary routine. Some patients only find out that hypertension is the culprit when it is time for dialysis. In China, hypertensive kidney damage is one of the top 3 causes of uremia.  The incidence of hypertensive kidney damage is directly proportional to the severity and duration of hypertension. Other possible influencing factors include gender, diabetes mellitus, hyperlipidemia, and hyperuricemia, which interact to further exacerbate renal damage. The age of onset of primary hypertension is typically 25-45 years, while the age of onset of clinical symptoms of hypertension-induced renal damage is typically 40-60 years. The earliest symptom may be increased nocturia and more frequent nighttime rising, followed by proteinuria. The degree of proteinuria is usually mild to moderate (+ or ++), and the 24-hour urine protein quantification usually does not exceed 2 grams, but a few patients can have large amounts of proteinuria. The urine sediment microscopy has few red blood cells and tubular patterns, and transient hematuria may occur in individual patients.  Most patients with hypertensive kidney damage have no obvious symptoms in the early stage, some only show weakness or lumbago, some have increased nocturia or cloudy urine, regular monitoring of urine routine, 24-hour urine protein quantification and kidney function should be performed.  The patient’s mental pleasure and moderate exercise play a great role in cooperating with the treatment and improving the efficacy of treatment. And a reasonable diet is beneficial to delay the progress of the disease. Patients should analyze their diet under the guidance of doctors, change bad eating habits and meet nutritional requirements: 1. low salt, should be reduced to less than 6g per day, i.e. after removing the gel pad of ordinary beer lid, a flat lid of salt is about 6g, avoid salt-pickled food, food with preservatives should also be eaten less.  2, limit fat intake, cooking with vegetable oil, can eat more sea fish.  3, protein is an essential nutrient, but if the protein intake is too high, it will increase the burden on the kidneys and aggravate the kidney damage, if the intake is not enough, it will affect the body’s nutrient supply. Therefore, patients should decide the protein intake according to the kidney function status: when there is no obvious kidney function damage, the protein intake is controlled at about 50g per day; if there are obvious abnormalities such as blood creatinine and urea nitrogen, the protein intake should be reduced to 20-40g per day. 4.High vitamin diet, adequate intake of vitamins especially B vitamins, and vitamin supplements can be taken if necessary.  If you have a history of hypertension for more than 5-10 years and have experienced increased nocturia and more foam in the urine, you should promptly visit the nephrology department of a regular hospital to select appropriate antihypertensive drugs to control blood pressure in the ideal range, delay the development of kidney damage, and avoid the use of nephrotoxic Chinese and Western drugs. As long as timely detection and proper treatment, the course of hypertensive kidney damage usually progresses slowly, and only a small number of them develop into renal failure.