Basics about Hypertensive Nephropathy

2014-03-31 09:57

Hypertensive Nephropathy (HN) is a medical condition referring to damage to the kidney due to chronic high blood pressure. It should be distinguished from "renovascular hypertension", which is a form of secondary hypertension.

In the kidneys, as a result of benign arterial hypertension, hyaline (pink, amorphous, homogeneous material) accumulates in the wall of small arteries and arterioles, producing the thickening of their walls and the narrowing of the lumina — hyaline arteriolosclerosis. Consequent ischemia will producetubular atrophy, interstitial fibrosis, glomerular alterations (smaller glomeruli with different degrees of hyalinization - from mild to sclerosis of glomeruli) and periglomerular fibrosis. In advanced stages, renal failure will occur. Functional nephrons have dilated tubules, often with hyaline casts in the lumens. Additional complications often associated with Hypertensive Nephropathy include glomerular damage resulting in proteinuria and hematuria.Wants to know some details?please chat with our online doctor.

According to the 2011 US Renal Data System (USRDS) data, in the year 2009, Hypertensive Nephropathy (HN) accounted for 28% of patients reaching end-stage renal disease (ESRD). The rate of ESRD attributed to hypertension has grown 8.7% since the year 2000. HN is reportedly the second most common cause of ESRD in white people (23%) and is the leading cause of ESRD in black people (46%).

Most patients reaching ESRD from any cause are hypertensive, with nephrosclerosis being the classic finding in end-stage kidneys. Regardless of the etiology, once hypertension develops, a cycle of renal injury, nephrosclerosis, worsening of hypertension, and further renal injury is established. As a result, in a patient presenting with ESRD, determining whether nephrosclerosis is the cause or the consequence of chronic renal injury may be difficult.

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