From this article you will learn what is kidney pressure: symptoms and treatment of pathology. Causes, types of disease, diagnosis.
Contents of the article:
- Three types and causes of the pathology
- Symptoms of renal pressure
- Diagnosis
- Treatment methods
- Incidence statistics and prognosis
Renal pressure is the "popular" name for nephrogenic arterial hypertension. This is the increased pressure that arises from kidney disease.
The pressure due to renal diseases is increased because the affected organs produce more renin. It is an enzyme from which angiotensin is formed. Being in excess in the body, angiotensin provokes the production of more aldosterone - a hormone that raises blood pressure.
In addition, the affected kidney tissue synthesizes less angiotensinase - an enzyme that destroys excess angiotensin.
If symptoms of nephrogenic arterial hypertension occur, consult a physician first. And he will already send you to a nephrologist - a specialist in kidney disease.
Nephrologist examines the patient The disease can be cured only if it is identified at the initial stage.
Three types and causes of the pathology
Depending on the renal disorder that causes increased blood pressure, 3 types of nephrogenic arterial hypertension are distinguished:
- Vasorenal.
- Parenchymal.
- Mixed.
1. Vasorenal appearance of pathology
Occurs because of vessel pathologies. These can be:
- fibromuscular renal artery dysplasia;
- her stenosis;
- thrombosis;
- aneurysm;
- panarteritis( inflammation of all layers of the vessel wall).
Renal aneurysm 2. Parenchymal species
Occurs due to diseases of the underlying renal tissue:
- pyelonephritis;
- of glomerulonephritis;
- of kidney tuberculosis;
- hydronephrosis;
- of diabetic glomerulosclerosis and others.
3. Mixed form of
Occurs because of defeat and parenchyma of the kidneys( its main tissue) and renal vessels at the same time. This happens with the following diseases:
- benign or malignant tumors, polycystosis;
- nephroptosis;
- combination is listed in the previous two lists of diseases.
Symptoms of renal pressure
Pathology manifests itself in two groups of symptoms: symptoms of high blood pressure and manifestations of kidney disease.
The slow-flowing form of renal pressure can be recognized by the following symptoms:
- persistent high blood pressure( both upper and lower);
- headache;
- dizziness;
- reduced performance;
- weakness in muscles;
- shortness of breath;
- a strong palpitation feeling and chest discomfort.
With the fast flowing form, the following symptoms appear:
- strongly increased lower pressure( 120 mm Hg and higher);
- decreased visual acuity;
- permanent headache, especially in the occiput;
- dizziness;
- nausea and vomiting.
In any form of nephrogenic arterial hypertension, in addition to these symptoms, the patient also complains of pain in the lumbar region( blunt, pulling or sharp).
Diagnosis
The first indication that a doctor can suspect a disease is a small difference between upper and lower pressure( less than 30 mmHg)
In this case, the doctor prescribes a comprehensive kidney examination, urinalysis, eye fundus diagnostics and blood tests.
Renal Pressure Diagnosis:
| Kidney ultrasound | Allows you to detect signs of pyelonephritis, as well as see tumors. |
|---|---|
| Ultrasonic Doppler Angiography | Arterial Examination. Allows to examine in detail the state of the vessel: the thickness and structure of the wall, the speed of blood flow. |
| Angiography with contrast material | Allows you to assess the state of renal vessels, to detect constriction. |
| Excretory urography | Radiographic examination using contrast medium. Allows you to estimate the size, shape and location of the kidneys. |
| MRI or CT of the kidneys | Allows detailed visualization of the kidneys and their vessels. |
| Kidney biopsy | Evaluates the state of the kidneys at the cellular level. Due to this, it is possible to determine the degree of kidney damage by any disease. A biopsy is also performed with tumors to determine their composition. |
| Investigation of the fundus | With renal pressure, retinal pathologies occur more often than with normal hypertension. |
Methods for diagnosing renal pressure Blood tests for renal pressure:
| The renin | plays a crucial role in the diagnosis of the disease. |
|---|---|
| On catecholamines | Differential diagnosis with pheochromocytoma. At the last catecholamines are increased. |
| On aldosterone | If it is elevated, and renin is normal, the patient may have adrenal tumors. |
Treatment methods
It is aimed at eliminating the underlying disease. Also used and medicines for symptomatic treatment of high blood pressure.
Renovascular nephrogenic arterial hypertension can be cured by vascular surgery:
- balloon dilatation;
- resection of the renal artery;
- Prosthetics of the renal artery.
We briefly discuss the treatment of other kidney diseases:
- Parenchymal is treated with medications.
- In chronic pyelonephritis, the doctor prescribes anti-inflammatory drugs( eg, Diclofenac, Paracetamol, Metamizol), antibiotics( Cefotaxime, Ceftriaxone, Ciprofloxacin), sometimes antifungal( if inflammation is caused by a fungus: Amphotericin, Fluconazole).
- For hydronephrosis, it is recommended to take antispasmodics( No-Shpa, Papaverin), broad-spectrum antibiotics( Augmentin, Ciprofloxacin, Cefodox), diuretics( Torasemide, Furosemide), anti-inflammatory( Nimesil), analgesics.
- For the treatment of tuberculosis of the kidneys, antituberculous agents are prescribed( Isoprinosine, Ethambutol, Rifampicin and others).
- Glomerulonephritis can not be completely cured, as it is of an autoimmune nature. With this disease prescribe drugs that protect the kidneys from further damage and lowering the pressure. These are ACE inhibitors( lisinopril, captopril), angiotensin receptor blockers( Lozartan, Valsartan), direct renin inhibitors( Aliskiren, Remikiren, Zankiren).Sometimes, glucocorticosteroids( hydrocortisone) and cytostatics( Azathioprine) are prescribed.
- For the treatment of renal pressure of mixed etiology, surgical treatment is used.
- Renal tumors are primarily removed. Further treatment depends on the origin of the neoplasm.
- Nephroptosis is eliminated with nephropexy - fixing the kidney in the correct position by attaching it to other organs.
Drugs for chronic pyelonephritis 
Drugs for hydronephrosis If only one kidney is affected and therapy is ineffective, radical treatment is used - complete or partial nephrectomy( removal of this organ).This is necessary in order to eliminate arterial hypertension, which will provoke the defeat of the second kidney. If both kidneys are badly affected, then at least one of them will need to be transplanted( while the second one is simply removed or a new one is transplanted in its place).
In any form of nephrogenic arterial hypertension, antihypertensive drugs are used( as in the treatment of hypertension of any origin).To reduce blood pressure, ACE inhibitors( Captopril) are used. But prolonged symptomatic therapy without eliminating the underlying disease leads to wrinkling of the organ. And with bilateral stenosis of the renal arteries, it is generally contraindicated.
Incidence statistics and prognosis
In 35% of cases, the cause of high blood pressure is various kidney lesions. Therefore, if you have increased blood pressure and you were not previously predisposed to hypertension, first examine the kidneys.
| Prognosis for a vasorenal version of | Prognosis for parenchymal type |
|---|---|
| After surgical treatment - favorable | At an early stage - favorable |
| Without surgery - unfavorable( the disease progresses rapidly and causes irreversible changes in the tissues of the organ) | At a late stage without surgery - unfavorable |
| At a late stagestage with unilateral lesion after unilateral nephrectomy - conditionally favorable | |
| At the late stage with bilateral lesion - unfavorable, prtransplantation - relatively favorable |
