Early renal failure with high blood pressure

Hypertension is a common disease that mostly occurs in adults or the elderly. For the elderly, the metabolism of cells slows down and the body functions decline. If you have hypertension, you will often feel dizzy and nauseous, and your sleep quality will decrease. In severe cases, it will lead to kidney failure. The kidney is a very important organ in the body. If it fails, the body will fall into a weak state. Let us learn about it together. 1. Cause of disease: The kidneys themselves are used to filter toxins in the body, excrete excess water and sodium salts through urine, and prevent proteins, blood cells, etc. from leaking out of blood vessels. Hypertension increases the blood pressure in blood vessels, causing protein to leak into the urine. Once the protein leaks out, it will damage the kidney's filtration system. If hypertension is not well controlled for a long time, the structural damage caused will be difficult to reverse, and renal function impairment and even chronic renal failure will gradually occur. The final serious stage is uremia. 2. Clinical manifestations: Patients with benign hypertensive nephrosclerosis are mostly over 40 to 50 years old and have a history of hypertension for more than 5 to 10 years. In the early stage, there is only increased nocturia accompanied by microalbuminuria, followed by proteinuria (generally + to ++), and some patients may have a small amount of erythrocyte urine. Hypertension can lead to complications in other organs: arteriosclerotic retinopathy, left ventricular hypertrophy, and stroke. The disease progresses slowly, and a small number of patients gradually develop into renal failure, while most patients have mild renal damage and abnormal urine routine.

Malignant hypertension and nephrosclerosis are characterized by diastolic blood pressure > 130 mmHg, hematuria (microscopic or even macroscopic hematuria), proteinuria, or even oliguria or anuria. Renal function tests show a rapid increase in blood creatinine, which can develop into uremia in a short period of time. Malignant hypertension is often accompanied by damage to other organs, such as headache, drowsiness, convulsions, coma, blurred vision, decreased vision or even blindness, heart enlargement, and heart failure. 3. Examination 1. Physical examination

Long-term hypertension (≥140/90); some patients may experience eyelid and/or lower limb edema, heart enlargement, and arteriosclerotic retinopathy on fundus examination. When there are streak-shaped, flame-shaped hemorrhages and cotton-like soft exudates in the fundus, it supports malignant hypertensive nephrosclerosis. Patients with hypertensive encephalopathy may have corresponding neurological manifestations.

2. Chemical testing

Routine urine test shows protein + to ++, with or without occult blood. The 24-hour urine protein quantity is usually below 2 grams. Other examinations include increased urine microalbumin, NAG enzyme, β2-MG, urine concentration-dilution dysfunction, increased blood urea nitrogen and creatinine, etc.

3. Imaging examination

Ultrasound shows that there are usually no changes in the kidneys in the early stages, but when the disease develops into renal failure, the kidneys may shrink to varying degrees. Renal function damage can be seen in the early stages of radionuclide examination. Electrocardiogram often shows high left ventricular voltage; chest X-ray or echocardiogram often shows aortic sclerosis, left ventricular hypertrophy or enlargement.