Hypertensive Nephropathy: Symptoms, Stages, Diagnosis

Symptoms of Hypertensive Nephropathy
Severe edema: as the fist symptom,edema usually emergs systemic edema, and if the finger press ,it will appear sunken.Serious patients may also have pleural effusion and ascites.when pleural effusion and ascites is quiet a lot ,it possiblely cause difficute breathing,umbilical hernia or inguinal hernia. Highly edema is often accompanied by little urine, hypertension and mild azotemia.
Massive proteinuria:massive proteinuria is the majoy performance of nephrotic syndrome.Urinary protein equalization almost be ++~++++ (urinary protein quality). Adults excetion of urinary protein ≥3.5g/d, almost selective proteinuria.
Hypoproteinemia:plasma protein descends,seralbumin<30g/L,serious are less than 10g/L .
Hyperlipemia:cholesterol，triglycerides and so on are all obviously rise.
Stages of the Hypertensive Nephropathy
In the clinical,hypertensive nephropathy has been divided into the following stage according to
the patient's condition and the laboratory test.
Ⅰstage--microalbuminuria: characterized by the abnormal rate of urinary albumin excretion. Renal function is normal,and urine conventional protein is negative. (Routine urine test )
Ⅱ stage--clinical proteinuria:characterized by the positive urine conventional protein,the ration of proteinuria>0.5g.Renal function is normal.
III stage--Renal insufficiency:characterized by Ccr dropping and SCr rising. Divided into non-dialysis period and dialysis period (uremia).
Non-dialysis period:Ccr is in 40～10ml/min，133μmol/L
Dialysis period (uremia):Ccr<10ml/min. Scr>707μmol/L.
Differential diagnosis
Diagnosis of Hypertensive Nephropathy
The age is mostly above 40-50 years, and the history of hypertension is above 5-10 years.In the early stage ,only nocturia increases,hereafter then proteinuria appears. Due to broken capillaries, Individual cases may occur transient gross hematuria, but not accompanied by lumbago. Frequently merge arteriosclerotic retinopathy,left ventricular hypertrophy,Coronary heart disease,cerebral arteriosclerosis ,and(or) the history of cerebrovascular accident.Course of the disease progresses slow,small part gradually developes into renal failure,most of renal function is damaged mildly year in year out ,and urine convention is abnormal.The diastolic blood pressure of malignant hypertension needs achieve more than 16Kpa (120mmHg),accompanied by obvious heart brain complications and developed fast,a great quatity of protreinuria always accompanied by hematuria,and progressive loss of renal function