The kidney damage caused by hypertension is mainly small arteriosclerosis, one is benign renal small arteriosclerosis and the other is malignant small arteriosclerosis. When hypertension occurs, due to increased secretion of norepinephrine, increased sympathetic nerve activity, and increased renin-angiotensin, it causes spasmodic contraction of small blood vessels throughout the body, and the small blood vessels of the kidney are particularly prominent. Combined with increased pressure load, damage to the endothelium of blood vessels is likely to occur, with vascular vitreous degeneration and fibrous hyperplasia, resulting in thickening of the vessel wall, narrowing of the lumen, and degeneration. Renin-angiotensin and hypertension also contribute to increased vascular wall permeability, and fibrinogen in the blood can penetrate into the vessel wall, accelerating vascular sclerosis. In addition, excessive renin-angiotensin has a “vasculotoxic” effect, and its increase causes necrotizing small arteritis in small renal arteries, and elevated blood pressure itself can also cause such pathological changes in small renal arteries, leading to renal failure. Hypertensive kidney damage can occur in people with the following conditions, so a clear medical history should be taken in the diagnosis: ①Patients with primary hypertension, especially those with combined risk factors such as diabetes mellitus; ②Generally have more than 5 years of persistent hypertension (before the appearance of proteinuria); ③Persistent proteinuria; ④Except for various primary kidney diseases; ⑤Patients with retinal atherosclerosis or atherosclerotic retinal changes; ⑥Other secondary kidney (6) Other secondary renal diseases were excluded. Renal impairment should also be considered for those with the following ancillary conditions: ① age 40-50 years or older; ② hypertensive left ventricular hypertrophy, coronary artery disease, heart failure; ③ history of cerebral arteriosclerosis or cerebrovascular accident; ④ elevated blood uric acid; ⑤ glomerular impairment preceding glomerular impairment; ⑥ slow progression of disease.