OVERVIEW
OVERVIEW
Benign small artery nephrosclerosis is a type of hypertensive renal damage in which the small arteries of the kidney slowly develop from long-term hypertension or aging of blood vessels, which ultimately impairs the function of glomeruli and tubules. Hypertension is divided into primary and secondary. Primary hypertensive renal damage can be categorized into benign small artery nephrosclerosis and malignant small artery nephrosclerosis according to pathological changes. The disease is most common in middle-aged and elderly people over 50 years old, and is more common in men, with a long history of slowly progressive hypertension, mostly accompanied by risk factors such as smoking and alcohol abuse.
Whether medical insurance
Yes
Department
Nephrology
Clinical symptoms
The manifestations of tubular damage such as increased nocturia and polyuria appear in the early stage, and glomerular function damage may appear in the late stage. Some patients have a small amount of proteinuria, mainly small molecule protein.
Hazards
With the development of the disease, renal function gradually decreases. Long-term renal ischemia can lead to renal atrophy and develop into renal failure.
Complications
Renal failure.
Examination
Physical examination, blood routine, urine routine, renal function tests, urine protein quantification, electrolytes, ultrasound, CT, renal arteriography, renal biopsy and so on.
Diagnosis
History of primary hypertension, proteinuria is usually preceded by a history of persistent hypertension for more than 5 years, etc. Combined with ultrasound and renal biopsy, the diagnosis can be made clearly.
Treatment principle
The key to treatment is to effectively control blood pressure and delay renal damage, as well as to quit bad habits and treat high uric acid and hyperlipidemia.
Curability
Symptoms can be relieved and condition can be improved.
Dietary recommendations
Limit salt, alcohol, and appropriate adequate carbohydrates. Those with combined hyperlipidemia should appropriately restrict fat intake. Patients with renal insufficiency should control the intake of protein and phosphorus according to the degree of renal impairment.
Causes
Etiology
It is caused by long-term uncontrolled benign hypertension, and the pathological changes and corresponding clinical manifestations of benign small-artery nephrosclerosis may appear when the hypertension lasts for 5 to 10 years.
Symptoms and Diagnosis
Typical symptoms
History of hypertension, age of onset between 40 and 60 years old; early onset of tubular damage such as increased nocturia and polyuria, late onset of glomerular damage. Some patients have a small amount of proteinuria, mainly small molecule protein.
Diagnostic basis
1. history of primary hypertension, proteinuria is usually preceded by a history of persistent hypertension for more than 5 years. 2. retinal atherosclerosis or atherosclerotic retinal changes. 3. age over 40 years old, with left ventricular hypertrophy, cerebral vascular sclerosis, or history of cerebral vascular accidents. 4. renal tubular function damage prior to glomerulonephritis function damage, and the disease progresses slowly. 5. renal puncture biopsy can be a clear diagnosis.
Treatment
Treatment guidelines
The key to treatment is to control the blood pressure effectively, and at the same time, quit the bad habits and treat high uric acid and hyperlipidemia. If there is already renal decompensation, treat it as chronic renal failure.
Drug therapy
Calcium antagonist, angiotensin-converting enzyme inhibitor, etc.
Prognosis
Prognosis can be improved with treatment.
Nursing care
Daily care
1. Appropriate activities, pay attention to rest. 2. Blood pressure monitoring, strict control of blood pressure. 3.
Diet regulation
Low salt and low fat diet, avoid oily and stimulating food.