Afferent arteriole hyalinosis

Introduction The aortic glass-like lineage is caused by systemic hypertension, and is listed as the second disease (about 25%) that causes end-stage renal failure in Western countries. The incidence rate in China is also increasing. The disease can be divided into two types: benign arteriolar nephrosclerosis and malignant arteriolar nephrosclerosis.

Cause

Benign small arteriosclerosis is caused by long-term uncontrolled high-grade hypertension. The higher the blood pressure and the longer the duration, the heavier the lesion. The arterial lesions are mainly the hyaline wall of the afferent arterioles, and the thickening of the interlobular arteries and the intima of the arcuate artery wall, which cause ischemic renal parenchymal damage.

an examination

Related inspection

Renal function check blood pressure

Necessary conditions for diagnosis:

1 is essential hypertension.

2 There is generally more than 5 years of persistent hypertension before proteinuria occurs (the degree is generally >20.0/13.3 kPa (150/100 mmHg).

3 There is persistent proteinuria (generally mild to moderate), and there are few forms in the microscopic examination.

4 have retinal arteriosclerosis or arteriosclerotic retinal changes.

5 Excluding various primary kidney diseases.

6 Except for other secondary kidney diseases.

Auxiliary or reference conditions:

1 age is over 60 years old.

2 have hypertensive left ventricular hypertrophy, coronary heart disease, heart failure.

3 have a history of cerebral arteriosclerosis and/or cerebrovascular accident.

4 blood uric acid increased.

5 renal tubular dysfunction precedes glomerular dysfunction.

6 The course of disease progressed slowly.

Differential diagnosis

Differential diagnosis of goblet aorta glassy changes:

1. Chronic glomerulonephritis secondary hypertension: if the medical history is very clear, there is no difficulty in identification, patients with chronic glomerulonephritis have abnormal urine, hypertension is later; and patients with benign small arteriosclerosis have hypertension. Before the kidney damage for more than 10 years.

2. Chronic pyelonephritis: manifested as chronic progressive hypertension and renal reduction. However, in the past, there was a history of urinary tract infections, urinary system symptoms and urinary changes occurred before the occurrence of hypertension; the number of pus cells in the urine was high, and common bacteria cultured had pathogenic bacteria.

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