What Is Nephrosclerosis?

Renal sclerosis includes arterial renal sclerosis due to renal atherosclerosis, and benign and malignant renal sclerosis due to hypertension. Renal atherosclerosis is part of systemic atherosclerosis and is more common in the elderly with or without hypertension. ^[1]

Nephrosclerosis

Basic Overview of Renal Sclerosis

Causes of kidney sclerosis

1. Arterial sclerosis: The pathogenesis is the same as atherosclerosis in other organs.

2. Benign renal sclerosis: Hypertensive vascular disease and glomerular hypertension can cause glomerular damage. Vascular and glomerular lesions of benign sclerosis can also be seen in the elderly, even in patients without hypertension. These changes may be related to the progressive decline of GFP in the elderly.

3 Malignant renal sclerosis: The initial lesion was a damage to the vessel wall caused by a sharp rise in blood pressure. ^[2]

Clinical manifestations of renal sclerosis

Patients with arterial nephrosclerosis can show signs of systemic atherosclerosis, such as heart, brain and peripheral vascular sclerosis, with or without hypertension. The symptoms of benign phase of essential hypertension include overweight, headache, dizziness, palpitations, shortness of breath, mental stress, and pain in the precardiac area. The manifestations of the malignant phase include headache and hypertensive encephalopathy, weight loss, and visual impairment. In the early stages of renal cirrhosis, backache, back pain, edema, hematuria, nocturia, etc. are seen, and in the later stages, renal failure is seen.

Patients with arterial sclerosis see symptoms of systemic atherosclerosis, such as the manifestations of heart, brain and peripheral vascular sclerosis, with or without hypertension. The blood pressure of the benign phase of primary hypertension usually rises moderately, eventually leading to congestive heart failure or cerebrovascular accident, and only a few patients die from renal failure. Diastolic pressure in malignant phase is usually above 130mmHg, depending on papillary edema, sometimes bleeding and exudate can be seen, often leading to renal failure. ^[3]

Kidney sclerosis auxiliary examination

1. Blood routine and urine routine.

Urine analysis: proteinuria. red blood cells: mainly seen in patients with malignant stage, gross hematuria in severe cases

2. Renal function test: In patients with benign stage, mild and moderate hypertension generally has no effect on renal function. Most of the severe hypertension lowers GFP to 65ml / min. Before renal insufficiency, hyperuricemia may occur. It is an earlier manifestation, reflecting the decrease in renal blood flow caused by arterial and arteriolar disease.

3 Kidney biopsy. ^[4]

Differential diagnosis of kidney sclerosis

1. Renovascular hypertension

Showed as hypertension. But it is more common in young people, with normal blood pressure in the past; upper abdomen and vascular murmurs can be heard; venous urography has a length difference of more than 1.5 cm between the long axes of the kidneys; renal arteriography shows the narrowing of the main renal artery and expansion after stenosis;

2. Chronic pyelonephritis

It is manifested by chronic progressive hypertension and shrinkage of both kidneys. However, there is a history of urinary system infection in the past. Urinary system symptoms and changes in urine appear before hypertension occurs. There are a large number of pus cells in urine, and pathogenic bacteria are found in common bacterial cultures. ^[5]

Treatment for nephrosclerosis

1. Symptomatic treatment.

2. Actively treat primary disease.

Patients with renal sclerosis generally have a better prognosis, with only a few cases progressing to renal failure. ^[6]

Kidney sclerosis diet note

The kidney sclerosis diet should pay attention to:

1. Absolutely no alcohol.

2, choose skim milk or yogurt.

3. Eat no more than 2 egg yolks per day.

4, avoid animal oil; the total amount of vegetable oil does not exceed 20 grams.

5, do not eat animal offal (ie, water, goods), chicken skin, fatty meat and fish roe, crab yellow.

6, avoid fried food.

7. Don't eat chocolate.

8, often eat less soy products and gluten.

9, eat 500 grams of fresh green vegetables every day.

10, after eating fruit to reduce the amount of staple food, eat an apple a day, you should reduce the staple food by 50 grams.

11, yam, sweet potatoes, taro potatoes, etc., should be replaced with staple food rice, flour, the total amount should be limited.

12, the daily intake of salt is limited to 5--6 grams.

13. Onion, garlic, ginger, pepper and other "four spicy" can be eaten, but should not eat more.

14, often eat fish, shrimp and other seafood.

15, fat-reducing foods are: oats, millet and other coarse grains, black sesame, black fungus, kelp, fray and cauliflower and other green fresh vegetables.

16, dinner should be eaten less, do not eat before going to bed.

17. Use 30 grams of hawthorn, 15 grams of cassia seeds every day, and add 1000 ml of water to replace tea.

18. If fatty liver causes abnormal liver function, or transaminase is elevated, you should take lipid-lowering drugs, enzyme-lowering drugs and fish oil health products under the guidance of a doctor, but you should not take too much. ^[7]

Preventive measures for kidney sclerosis

(A) diet

Should not eat spicy and fatty taste, enter a low-salt diet, quit smoking and alcohol, diet is modest, usually a light vitamin-rich diet, you can choose the following diet based on the condition.

(Two) daily life

Have a regular life, often participate in appropriate physical exercise, pay attention to work and rest.

(Three) dialectical care

Conduct psychological counseling for patients to build confidence in treatment. At the same time, teach the patients some methods to control their emotions and adjust their mentality. Arrange a comfortable environment for the patient, keep the ward quiet, avoid noise and shake the bed frame, and the light should not be too strong. Yin deficiency is the main one, eat less ginger, mutton and other foods, eat more Yang Yin products; Yang deficiency, pay attention to keep warm, eat cold cold products. ^[8]