Hypertensive nephropathy, as referred to here, refers broadly to renal failure caused by long-term hypertension. Nephrosclerosis, which has a corresponding name in the diagnosis of the disease, usually occurs in older patients who have a history of hypertension for many years, have less than 1 gram of urine protein per day, and do not have other renal lesions in combination. Hypertension and nephropathy are often causally related, and because most patients with renal failure do not undergo renal puncture (kidney biopsy), the incidence of “nephrosclerosis” is likely to be overestimated. The kidney blood flow accounts for about 1/5 to 1/4 of the cardiac blood output, and since the kidney is composed of numerous microvascular clusters, hypertension will undoubtedly harm the kidney. Long-term hypertension leads to atherosclerosis or even blockage of the arteries. If the lesion is located in the renal artery, renal infarction occurs; the patient will develop proteinuria and blood pressure will rise even more. Once the renal blood vessels are blocked or sclerosed, renal blood flow is relatively reduced, and renal function then decreases. The kidneys are normally responsible for water and electrolyte balance in the body. Once the function is impaired, water and electrolyte imbalance, blood volume increases, coupled with the rise in renin secretion, vasoconstriction, blood pressure becomes more and more high, which will undoubtedly add to the damage to the kidneys. Therefore, hypertensive patients must be careful to control blood pressure. Hypertension and kidney injury can, to a certain extent, promote each other and influence each other, aggravating the development of the disease. Is hypertensive nephropathy the same as renal hypertension? Hypertensive nephropathy can have no structural and functional changes in the kidney in the early stage, which refers to the long-term hypertension, causing renal arteriosclerosis and reduced renal blood flow, which further leads to impaired kidney function and eventually kidney shrinkage, and we call the shrunken kidney as “granular kidney”. In contrast, renal hypertension may or may not show hypertension in the early stage, referring to the long-term development of chronic kidney disease, the accumulation of water and sodium in the body, and the imbalance of some endocrine hormone regulation affecting blood pressure, resulting in an increase in blood pressure. Therefore, the etiology and early pathogenesis of the two are not the same, but hypertension itself is a risk factor for kidney disease, and kidney disease will appear symptoms of hypertension, so the two interact in the middle and late stages, and together aggravate the development of the disease, regardless of whether hypertension is in front or nephropathy in the first place, and eventually may develop into renal insufficiency and uremia. In principle of treatment, these two should be the same, both should actively control blood pressure and protect the kidneys.