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.
