How to judge hypertensive nephropathy

summary

I had a low fever these days, and it lasted for several days, but it didn't go away. Later, my waist began to ache, and my whole body was not good, so I had to go to the hospital for examination. The examination report showed that I had hypertensive nephropathy. Today, let me talk with you about how to judge hypertensive nephropathy.

How to judge hypertensive nephropathy

First: should exclude all kinds of secondary hypertension, especially chronic nephritis hypertension. Malignant renal arteriosclerosis should be differentiated from acute progressive nephritis and systemic vasculitis.

Second: acute exacerbation of chronic glomerulonephritis, IgA nephropathy, acute progressive glomerulonephritis, etc. Acute attack of chronic glomerulonephritis is more common in young and middle-aged patients. In the past, they often had a history of repeated edema or proteinuria. This symptom often appeared within one week after the precursor infection. The blood pressure increased significantly, and continued and stable. It was often accompanied by decreased serum albumin, anemia and obvious renal function (especially glomerular function) damage. Although nephropathy often occurred after Streptococcus infection, it also had symptoms Hematuria or proteinuria, but its latency is short (several hours to several days after infection, the patient's serum is increased, complement C3 is normal, and it depends on renal biopsy if it is difficult to identify; the onset of acute progressive nephritis is very similar to acute nephritis, but the former's condition progresses rapidly, the patient often appears uremia within a few days, the blood pressure rises obviously, and the treatment response is poor.

Third: most of them are mild to moderate proteinuria, 24-hour quantitation is 1.5-2.0g; microscopic examination of visible components (red blood cells, white blood cells, transparent tube type) is less, hematuria may occur; early blood uric acid increases, urinary NAG enzyme, β 2-mg increases, urine concentration dilution dysfunction; CCR decreases slowly, blood urea nitrogen, creatinine increases. Renal tubular function damage is more than glomerular function damage

matters needing attention

The prognosis of patients with kidney disease, especially hypertensive nephropathy, is poor. The disease often progresses and slowly enters the uremic stage of renal failure. Therefore, it is of great significance to actively treat kidney disease and control hypertension to prevent the progress of chronic renal damage