Source _ general knowledge of hypertension of the kidney

Source _ general knowledge of hypertension of the kidney
Hypertension directly caused by kidney trouble is called kidney hypertension, account for 5- 10% of adult's hypertension, it is a main component of continuing hair hypertension.
Kidney blood vessel hypertension and substantive hypertension of the kidney
It causes ischemic hypertension that causes of the kidney to become one kind alone, is called blood vessel hypertension of kidney that the renal artery is narrow, in whole kidney still as half proportion under hypertension. And hypertension caused by side or the dualth side kidney essence disease of other forms, referred to as substantive hypertension of the kidney, nearly every kind of kidney essence disease can cause hypertension. Various kidney trouble causes the chance, property of pathological change, impact on glomerulus function of hypertension, causes the intensity which is short of blood of the kidney essence and range of pathological change etc. and has something to do.
Hypertension that other nephropathy cause
The kidney of general glomerulus nephritis, lupus, inborn kidney development not congruent pathological change are relatively extensive, can be ischemic with vascular pathological change or kidney, so hypertension appears frequently, and kidney stone and pyelonephritis cause chances to continue taking place hypertension to be less. It is also different that chances of hypertension takes place in the glomerulus nephritises of different pathologic types, if small pathological change and membrane nephropathy have hypertension seldom, and whifves of hyperplasia nephritis, office cooking stove the intersection of segment and the intersection of and glomerulus harden extremely apt to appear hypertension. In addition, kidney hypertension relates to renal function state. The renal function fails blood pressure prones to raising, 80% of the the above, with hypertension of depleted later stage of renal function.
Kidney raised reason of blood pressure of hypertension
Factor influencing rising of blood pressure numerous at the kidney trouble, until the intersection of water and the intersection of sodium and blood capacity that retention lead to the fact increase, renin - the intersection of angiotensin and systematic the intersection of function and system increase, step down material such as prostaglandin in the kidney, bradykinin secrete reduce, the activity is weakened; Orthosympathetic excitability increases, cause the arteriolar convulsion of whole body; Can exchange sodium and renin relation and unusually wait.
Kidney hypertension is classified:
2 kinds of factors were the most important the above said before. On the basis of the the first 2 kinds of factors, kidney hypertension is divided into: Capacity reliance type hypertension and renin reliance type hypertension.
1,Reliance type hypertension of the capacity:After the material injury of kidney, the ability that the kidney deals with the sodium, water fails. When the intaking amount exceeds the excretion ability of the organism, namely water and sodium retention appear. Water and sodium retention, like mainly in the blood vessel, make the blood capacity expand, hypertension can take place. Water and sodium retention can make sodium content of inner water of smooth muscle cell of blood vessel increase at the same time, the blood vessel wall is increased thick, the elasticity is reduced, the vascular resistance and reactivity to the catecholamine are strengthened, and make the angiotensin 2 type improve to the receptor affinity of blood vessel, at this moment even if it can also make blood pressure rise that angiotensin is normal.
2,Renin reliance type hypertension:Its pathogenesis is narrow for renal artery, pour into and press reducing and kidney essence disease in the kidney, and secrete cell tumour of the renin, can make cells releasing a large amount of renin by the ball, cause angiotensin 2 activity to increase, the arteriolar tube wall of whole body shrinks and produces hypertension. Renin and angiotensin 2 can impel the aldosterone to secrete and increase, causes sodium water retention, make the blood capacity increase and produce hypertension. Because the release of kallikrein and prostaglandin reduces after kidney material injury. The reduction of the relaxation and blood vessel material is the important factor that hypertension is formed too. Hypertension is the common clinical manifestation of kidney trouble. There are obvious differences in cause of disease and pathogenesis between kidney blood vessel hypertension and substantive hypertension of the kidney, its prognosis has difference too. Blood vessel hypertension of kidney can employ the surgery method to cure, generally the therapeutic effect is better in early middle period.
In the continuation, severe hypertension can accelerate the renal function to worsen
Substantive hypertension of the kidney can be seen at acute nephritis, chronic nephritis, lupus nephritis, depleted one of renal function by causing with various reasons. Though kidney hypertension blood pressure rise, exert a bad influence to kidney conversely for kidney trouble due to. But the first passing hypertension, hypertension substantially as appearing at the time of acute nephritis, often have a little effect on renal function, and it is easier to treat. In the continuation and severe hypertension may accelerate the deterioration of the renal function.
Relatively difference of general type of prognosis of chronic nephritis hypertension type that we see on clinic; It is the important factor that a renal function worsens that the chronic kidney declines patient's blood pressure and raises.
Why is kidney trouble patient relatively bad with the hypertension person prognosis?
This in the continuation and severe hypertension will enable arteriolar convulsion of the kidney, harden, make the thin vascular sclerosis of mao of the glomerulus accelerate, the nephron is damaged and accelerated, the renal function shows a tendency to worsen obviously; Because blood pressure rise, also will cause serious heart, brain complication at the same time. Though it is very important to control blood pressure actively, can't think either that lower blood pressure the lower well. Should generally drop to decline the patient's hypertension to the mercury column of 150-140/95/90 millimetres as to the chronic kidney. In this way, can guarantee renal blood flow volume, has safeguarded the filterability of the glomerulus, and because blood pressure high to make kidney to be arteriolar hardening, accelerating by glomerulus capillary.
Protecting the renal function actively and effectively, control the intersection of kidney trouble and hypertension of patient play an important role in delaying the kidney and damaging, protecting the renal function actively and effectively. , there are obvious results too as to good control blood pressure, while guaranteeing blood pressure is steady in much nephropathy patient's treatments, the decrement gradually of depressor, some patients have also realized and got rid of and used medicine.
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