What is renal hypertension
Renal hypertension accounts for the major part of secondary hypertension and it is caused by renal parenchymal diseases or renal vascular diseases. With continuous decline of renal functions, blood pressure will become higher and higher and the incidence of high blood pressure is up to 83% among end stage renal failure patients.
What are the pathogenesis of renal hypertension
Renal hypertension can be divided into 2 types:
·capacity-dependent hypertension. When renal parenchyma is damaged, the kidneys can not remove excessive water and sodium out of the blood. The retention of water and sodium will expand blood capacity and increase blood pressure. What is more, the vascular wall will be thickened and its elasticity be much reduced. Increased vascular resistance and intensified reaction to catecholamine are all factors that can cause high blood pressure.
·renin-dependent hypertension. Renal artery stenosis, low renal perfusion pressure and renal parenchymal diseases can activate renin-angiotensin-aldosterone system. On one hand, this will cause small artery wall contraction in the whole body, and on the other hand, it will worsen water and sodium retention. What is more, reduced secretion of diastolic blood pressure materials like kallikrein and prostaglandin is also important pathogenesis for high blood pressure in kidney diseases.
In reality, the pathogenesis of renal hypertension is much more complex than the above classification and in some case the patients’ high blood pressure can not be explained by neither of the above reasons. The classification is mainly for better understanding, studies and effective treatments.
Kidney diseases that can cause renal hypertension
Renal hypertension can be further divided into renal parenchymal hypertension and renal vascular hypertension.
Renal vascular hypertension is caused by vascular diseases which are mainly renal artery lesions or oppression to renal artery.
Kidney diseases that can cause renal parenchymal hypertension include:
·Polycystic kidney disease
·Congenital renal agenesis
·Renal medullary cystic disease
Treatment options for renal hypertension
Non-medicine therapy. Non-medicine therapy are mainly proper diets, healthy lifestyles, proper regular exercises and good mood.
Medicines for renal hypertension include diuretics, calcium channel blockers, ACEI and ARB. Usually in the beginning, small dosage will be given and then the dosage can be gradually increased and the combination of more than one drugs can help improve curative effects and at the same time reducing side effects.
Micro-Chinese medicines can effectively treat renal hypertension by the following curative mechanisms---dilating blood vessels, anti-inflammation, anti-coagulation and degradation of extracellular matrix.
What is more, persistent badly controlled high blood pressure will further worsen renal damages and speed up illness progression into end stage renal disease, therefore the earlier effective treatments are sought, the better the prognosis is.
The root cause of high blood pressure in kidney diseases is renal damage, therefore to lower high blood from the root, patients should first make clear which part of their kidneys are damaged, what is the severity of renal damages so as to seek effective ways to prevent further deterioration, repair damaged renal tissues and improve kidney functions.
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