Renal interstitial fibrosis

Introduction Renal interstitial fibrosis (RIF) is a common pathological process in which various chronic kidney diseases progress to end-stage renal failure. The pathological features are extracellular matrix in which normal renal interstitial and tubular structures are aggregated (extra cellular). Matrixc, ECM), such as type I, III, IV collagen, fibronectin (FN), laminin (LN), etc., ECM from fibroblasts, renal tubular epithelial cells and vascular endothelial cells Such as cell synthesis and secretion, of which fibroblasts are the main source of deposition of ECM, playing an important role in renal interstitial fibrosis. Renal interstitial fibrosis can lead to impaired renal function, and its treatment methods mainly inhibit fibroblast activity and ECM synthesis, and stimulate ECM degradation.

Cause

1, arterial nephrosclerosis: the pathogenesis is the same as the atherosclerosis of other organs.

2, benign renal sclerosis: hypertensive vascular disease and glomerular hypertension can lead to glomerular damage. Vascular and glomerular lesions of benign nephrosclerosis can also be seen in the elderly, even in patients without hypertension. These changes may be related to the progressive decline in GFP in the elderly.

3. Malignant nephrosclerosis: The initial lesion is a damage to the vessel wall caused by a sharp rise in blood pressure.

an examination

Related inspection

Renal angiography

Patients with arterial atherosclerosis show signs of systemic atherosclerosis, such as cardiac, brain, and peripheral vascular sclerosis, with or without hypertension. The blood pressure in the benign phase of primary hypertension is often moderately elevated, eventually leading to congestive heart failure or cerebrovascular accident, and only a few patients die of renal failure. The diastolic diastolic pressure is often above 130mmHg. The papilledema is a prominent feature, and sometimes bleeding and exudate can be seen, often leading to renal failure.

Differential diagnosis

Renal vascular hypertension

Expressed as high blood pressure. However, it is more common in young people. In the past, the blood pressure was normal; the upper abdomen could smell vascular murmur; the length of the long axis of the two urinary tract angiography was 1.5 cm or more; the renal artery angiography showed the stenosis of the renal artery and the expansion after stenosis;

2. Chronic pyelonephritis

It is characterized by chronic progressive hypertension and a reduction in both kidneys. 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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