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What Are The Diagnoses Of Hypertensive Nephropathy

2018-08-24 16:35

Hypertensive Nephropathy,DiagnosesWhat are the diagnoses of Hypertensive Nephropathy? Hypertensive nephropathy is a common disease in life. If patients with hypertension have albuminuria for a long time, it shows that you have hypertensive nephropathy. Many patients and their families are concerned about the treatment of hypertension. Before treatment, hypertensive nephropathy should be diagnosed so that patients can be early onset. Early detection and early treatment. It can effectively prevent the patient from getting worse.

What are the diagnoses of hypertensive nephropathy?

I. History and symptoms

Most of the patients are over 40-50 years old. The history of hypertension is more than 5-10 years. In the early stage, only nocturia increased, followed by proteinuria. In some cases, transient gross hematuria may occur due to rupture of capillaries, but not accompanied by significant low back pain. Arteriosclerotic retinopathy, left ventricular hypertrophy, coronary heart disease, heart failure, cerebral arteriosclerosis, and/or a history of cerebrovascular accidents are common complications. The course of the disease progresses slowly, a small number of them gradually develop into renal failure, and most of them suffer from impairment of renal function and abnormal urinary routine. Malignant hypertension requires more than 16 Kpa (120 mmHg), accompanied by obvious cardio-cerebral complications and rapid development, a large number of proteinuria, often accompanied by hematuria, progressive decline in renal function.

2. Physical examination found

Generally, the blood pressure increases continuously (20.0/13Kpa, 150/100mmHg or more); some eyelids and/or lower limbs edema, enlarged heart boundaries; most arteriosclerotic retinopathy, when the fundus of the eye striped, flaming bleeding and cotton flocculent soft exudation, support the diagnosis of malignant renal arteriosclerosis. Patients with hypertensive encephalopathy may have corresponding neurological signs.

3. Supplementary Examination

(1) mild to moderate proteinuria, 24-hour quantitative more than 1.5-2.0 g; microscopic examination of a few constituents (red blood cells, white blood cells, transparent tube type), may have hematuria; early blood uric acid increased, urine NAG enzyme, beta 2-MG increased, urine concentration-dilution dysfunction; more slow decline in Ccr, blood urea nitrogen, creatinine increased. Renal tubular dysfunction often precedes glomerular dysfunction.

(2) Imaging examination of the kidneys mostly unchanged, development of renal failure may occur when the kidney shrinkage in varying degrees; radionuclide examination of early renal damage; electrocardiogram often prompted left ventricular high voltage; chest X-ray or echocardiography often prompted aortic sclerosis, left ventricular hypertrophy or enlargement.

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