Hypertensive nephropathy overview: Difference between revisions

Jump to navigation Jump to search
Michael Maddaleni (talk | contribs)
No edit summary
 
Line 4: Line 4:


==Overview==
==Overview==
'''Hypertensive nephropathy''' is a medical condition referring to damage to the [[kidney]] due to chronic [[high blood pressure]].


It should be distinguished from "[[renovascular hypertension]]" (I15.0), 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 [[Lumen (anatomy)|lumen]]s — hyaline [[arteriolosclerosis]]. Consequent [[ischemia]] will produce tubular 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.
*'''Hypertensive nephropathy''' is a chronic medical condition, characterized by  [[kidney]] injury due to long-standing [[high blood pressure]].
*It should be distinguished from "[[renovascular hypertension]]", which is a type of [[secondary hypertension]].<br><br>
==Pathophysiology==
==Pathophysiology==
The [[kidney]]s may be damaged by or cause [[hypertension]]. Evidence from studies on renal transplant recipients and familial studies suggests a genetic component in occurrence of hypertensive nephropathy and nephrosclerosis.
 
 
*In the kidneys, as a result of ''benign [[arterial hypertension]]'', [[hyaline]] (pink, amorphous, homogeneous material) accumulates in the wall of small arteries and arterioles, leading to thickening of arterial walls and narrowing of the [[Lumen (anatomy)|lumen]]s — hyaline [[arteriolosclerosis]]. Consequently, tubular atrophy and [[interstitial fibrosis]] will occur.
*Glomerular alterations (smaller [[glomeruli]] with different degrees of hyalinization - from mild to severe glomerulosclerosis) and podocyte loss can increase the endothelial permeability and filtration of remaining glomerules, leading to microalbuminuria and development of [[CKD]]
*Some studies suggest a genetic component in the development of hypertensive nephropathy and nephrosclerosis.<br><br>
 
==Epidemiology and Demographics==
==Epidemiology and Demographics==
The incident counts and adjusted rates for hypertensive renal disease has been increasing gradually over the past three decades. 25,000 new cases of [[chronic renal failure]] attributable to [[high blood pressure]], are diagnosed every year in the US. It has also contributed significantly to the increase in the number of patients undergoing [[dialysis]] from [[renal insufficiency]].
 
 
*The incidence rate for hypertensive kidney disease has been increasing gradually over the past three decades.
*Annually, 25,000 new cases of [[CKD]] associated with [[hypertension]], are diagnosed in the US.  
*[[Hypertension]] is known as the second leading cause of [[ESRD]].<br><br>


==Diagnosis==
==Diagnosis==
===History and Symptoms===
==History and Symptoms==
Most of the patients with hypertensive nephropathy have no symptoms, although a majority give a history of being on medications for chronic [[hypertension]].
 
 
*Most of the patients with hypertensive nephropathy have no symptoms until kidney failure occurs.
 


==References==
==References==

Latest revision as of 06:49, 31 May 2020

Hypertensive nephropathy Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Differentiating Hypertensive Nephropathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Abdominal X Ray

CT

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypertensive nephropathy overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypertensive nephropathy overview

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypertensive nephropathy overview

CDC on Hypertensive nephropathy overview

Hypertensive nephropathy overview in the news

Blogs on Hypertensive nephropathy overview

Directions to Hospitals Treating Hypertensive nephropathy

Risk calculators and risk factors for Hypertensive nephropathy overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]

Overview

Pathophysiology

  • In the kidneys, as a result of benign arterial hypertension, hyaline (pink, amorphous, homogeneous material) accumulates in the wall of small arteries and arterioles, leading to thickening of arterial walls and narrowing of the lumens — hyaline arteriolosclerosis. Consequently, tubular atrophy and interstitial fibrosis will occur.
  • Glomerular alterations (smaller glomeruli with different degrees of hyalinization - from mild to severe glomerulosclerosis) and podocyte loss can increase the endothelial permeability and filtration of remaining glomerules, leading to microalbuminuria and development of CKD
  • Some studies suggest a genetic component in the development of hypertensive nephropathy and nephrosclerosis.

Epidemiology and Demographics

  • The incidence rate for hypertensive kidney disease has been increasing gradually over the past three decades.
  • Annually, 25,000 new cases of CKD associated with hypertension, are diagnosed in the US.
  • Hypertension is known as the second leading cause of ESRD.

Diagnosis

History and Symptoms

  • Most of the patients with hypertensive nephropathy have no symptoms until kidney failure occurs.


References

Template:WH Template:WS