Whether the compensatory period of hypertensive nephropathy can be maintained for 20 years is related to the degree of target organ damage, treatment effect and other factors. If the degree of target organ damage is mild, active treatment can slow down the progression of renal damage, and it is possible to maintain 20 years; if the degree of target organ damage is severe and the treatment effect is poor, with the development of the disease, it may progress to chronic renal failure, and it is usually unable to maintain 20 years. Hypertensive nephropathy is usually caused by damage to the small arteries of the kidneys or the renal parenchyma resulting from primary hypertension. Aggressive and effective control of hypertension is the fundamental measure to avoid or minimize the damage it causes to target organs, including the kidneys. If the blood pressure is under control with active treatment, the disease progresses slowly, and the compensatory period of hypertensive nephropathy may last up to 20 years at this point. If the blood pressure is not well controlled, especially when combined with other target organ damage such as cardiovascular, cerebrovascular, etc., the disease may progress to chronic renal failure faster, and then the compensatory period of hypertensive nephropathy usually can not be maintained for 20 years. Patients with hypertensive nephropathy are advised to go to regular hospitals in time and receive standardized treatment under the guidance of doctors.