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2015年1月18日星期日

How to Diagnose Hypertensive Nephropathy

How to diagnose hypertensive nephropathy? The damage of kidney disease caused by high blood pressure is mainly in blood vessels. The clinical manifestation mainly consists of damage in renal tubules and renal glomerulus. Renal tubules are more sensitive to the damage caused by insufficiency of blood in renal glomerular arteries, so the barrier of renal tubules appears earlier such as increased urine at night, increasedβ2 micro albumin in urine, NAG, decreased osmotic pressure in urine, lower specific gravity urine. The mark of damage in renal tubules is the appearance of micro-albumin. Later, in the conventional examination, the protein in urine shows positive and people come into renal failure stage.
In the early stage, there is only slight proteinuria. Protein in urine is from 1.5 to 2.0g. In microscopic, there are little red blood cells, white blood cells, casts in urine. hematuria can be seen. URIC increased, serum creatinine increases, as well.
In image examination, kidney nearly has no change. When it comes to renal failure, kidney will become atropic. The electrocardiogram indicates high tension in left ventricle. Chest X-ray or ultrasound shows aortosclerosis, lefe ventricular hypertrophy or expansion.

If we really have difficulty in diagnosis, we should do renal biopsy.

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