Hypertension is a big problem in modern worldDespite the big achievements in medicine, the control of arterial hypertension is not the easy task. Renal hypertension is a kind of arterial hypertension that develops with kidney disease. Such a kind of illness is called secondary.

This syndrome is 5-35% of the total hypertension that were diagnosed. Renal arterial hypertension It has characteristic signs. In addition to directly improving blood pressure, there is commitment to the young age, the lack of effect from medication treatment. It is worth noting that renal hypertension is malignant, and predictions with it are very bad.

Classification

The medicine distinguish the following varieties of illness:

1. Parenchimato renal hypertension (develops against the background of damage to the kidney tissues, as a rule, people with pyelonephritis, glomerulonephritis, polycystic, tuberculosis of the kidneys, nephropathy against the background of having a child).
2. Renovascular or differently vasorenal form (it is due to the fact that the artery is modified against the background of atherosclerotic processes, thrombos, aneurysmatic protrusion). As a rule, in the overwhelming amount of cases, this species appears in children up to ten years old, but the older age category has such a percentage of 50%.
3. The mixed variety combines the characteristics of parenchymal and arterial forms. There are people with the omission of kidneys, various formations and cysts, defects of the development of the kidneys.

Classification of the disease and its causes

How does pathology develop?

The mechanism of development is due to the assembly in the main functions of the kidneys. The main one is a filtration capacity with the release of water and sodium. Filtering pressure occurs due to the fact that there are some differences in the cross section of the vessel, which blood brings and the one that takes it.

Because of the various pathologies in the kidneys there is a decrease in the normal flow of blood to this body. It occurs ischemia of the YUKSTO-Glomerular apparatus. Its cellular system for this reason is exposed to hyperlastic and hypertrophic changes. It is made as a result of this large amount of renin. It is connected to a special substance (globulin), angiotensin 1 is formed, from which angiotensin 2 is obtained as a result of the cleavage of one molecule.

This compound has a very pronounced vasoconstrictor effect. In parallel with this, a large amount of angiotensin produced induces the production of aldosterone hormone, which is capable of delayed sodium in the body. Sodium fills the kidney vessels of the arterial bed, and more precisely accumulates in their walls, increasing their sensitivity to the hormones of catecholamic rows.

An important link of pathogenesis will be the fall in the production of kidney angiotensinase. In the organ without pathology, it is produced in sufficient quantity and breaks out angiotensin 2, thereby preventing its vasospascular effect. The damage to the renal tissue leads to a decrease in its action.

Renal hypertension is also associated with the fact that in diseases of the kidney masses, few compounds are secreted, which reduce pressure (prestaglandins, kininov). It follows that such a parables arises due to the reduction of the activity of angiotensinase, the synthesis of protesters and kinines and the activation of the renin-angiotensin-aldosterone system.

Why arises?

All reasons can be divided into those that have been from birth, as well as those that man acquired. Among the first to allocate:

1. Disconstructive and hypoplastic processes, blood clots and embols.
2. Fistula kidney between artery and veins.
3. Damage to the vessel.
4. Vices of the development of aortic, urinary system.

The factors that man acquired:

• atherosclerotic damage to vessels;
• renelization;
• aneurysmatic vessel protrusion;
• venosadarterial fistula;
• inflammation of the artery;
• compression of the vessel with a neoplasm or a pile;
• slipped tumor, hematomas or arteries cysts;
• stones in the kidneys.

Causes of renovascular hypertension in childhood

Manifestations

Symptoms of renal hypertension are very diverse. In general, the clinic consists of symptoms of damage to the kidneys and arterial hypertension. The degree of severity is depending on the form of the disease. With malignant - clinical manifestations Bright, disease develops quickly. And with a benign form of manifestation less pronounced, the dynamics of the ailment is gradual.

A benign form has a rather stable pressure, and diastolic, and systolic is also rising. Although a little more diastolic. Worried patient fatigue, weakness, shortness of breath, headache, pain in the heart.

But a malignant type of renal hypertension is characterized by a large increase in pressure, a decrease in visual acuity due to the blood retina with blood. It bothers the strong headache, stealing the head, vomiting can happen.

General features for both forms will be the attacks of heartbeat, panic, a decrease in cognitive functions (a person does not absorb material, does not remember many things). A constantly patient pursues headache, dizziness.

Since renal hypertension is always associated with kidney pathology, then, except for high pressure, there are also symptoms from the kidney:

• soreness in the lumbar region;
• students of the urge to preoccupy;
• the increase in the volume of the allocated urin;
• sometimes the body temperature can increase.

Signs from the kidney depend on the genesis of the disease (pyelonephritis, diabetes). An important feature that combines all types of illness discussed is refractoriness to various groups of antihypertensive drugs. It is important to note that the severity of the clinic is directly dependent on concomitant diseases (heart failure, heart attack).

Hypertension is developing in stages

How to diagnose?

Diagnostics develops from several stages. First of all, it is necessary to collect anamnestic data (the time of the disease, whether there is an effect from medicines, there is heredity, communication with a kidney disease, the malignancy of the flow). Based on a detailed survey, you can assume the origin of hypertension.

An important is the correct dimension of blood pressure. As a rule, with renal hypertension, a significant increase in numbers is detected, much more than with the usual form of illness. There is an increase in diastolic pressure, a decrease in pulse. When measuring, it is necessary to take into account the numbers and with the right, and from the left hand. If there is a significant difference between them, nonspecific aortoarterite has a place.

The systolic noise in the navel region will be a very specific feature of hypertension of the navel, they are associated with stenosis of renal vessels. Blood, passing a plot of narrowing, produces such a sound. But if there is an aneurysmatic protrusion, the noise becomes systodiastolic.

When atherosclerotic processes are present in the vessels (aorta and its big branches), the doctor can also listen to the epigastric areas of certain sounds that are moving to the femoral artery.

Highly great importance In the formulation of the right diagnosis, the study of the bottom of the eye, especially in the presence of visual sharpness. Hypertensive damage to the vessels of the eye leads to a narrowing of the main artery of the retina, you can observe the hemorrhages, the swelling of the retina, failure in the troopic nerve trophy. For severe course Pathology may even fall out of some fields of vision.

Timely diagnosis will avoid the development of a number of complications

Be sure to prescribe ultrasound procedure Kidney, such a method gives an idea of \u200b\u200bthe size, configuration, anomalies of the structure of the organ itself and its feeds of its vessels. Using ultrasound, it is also possible to determine the presence of pyelo and glomerulonephritis.

Excretory urography should also be performed in suspected the renal origin of hypertension. It helps to understand whether the kidney function is impaired or not. In addition, the statistical and dynamic variety of urography is applied.

Hinding the kidney Doctor determines on the basis of a picture in a vertical position, if there is a disease, the kidney displacement occurs more than one lumbar vertebra.

Doppleroangiographic examination is aimed at determining the pathology of the blood supply to the renal tissue. In this method, atherosclerosis is easily determined, the abnormality of the development of vessels.

As a gold standard of identifying the pathology of the vascular bed, the method of renal angiography with the use of contrast has been perfectly proven. It helps clearly reveal the size, position, for example, the narrowing of the vessel. To fulfill such research apply puncture femoral artery With the subsequent introduction of catheter and contrast into it.

Sometimes radioisotope scintigraphy is used with the introduction of radiisotope inside vein pharmacological means. But this method cannot determine the size and length of the pathological process.

At the moment, computer and magnetic resonance tomography are increasingly used to identify the causes of the disease. From laboratory methods, doctors use the determination of the concentration of renin in the blood, which flows from the kidney. However, this method can only be used with angiography. Evaluation of the kidney bioption helps determine which tissue lesion mechanism.

How to treat?

Treatment of renal hypertension should have an integrated approach. It is worth noting that in general it is hard to treat it, because hypertension is a malignant character, quickly affects the target organs (heart, eyes, brain). That is why therapy should be assigned immediately after the diagnosis is established.

The non-drug approach is that the patient is recommended to modify the lifestyle. It is necessary to reduce the number of consumed cooking salts. Medicase therapy of the disease is intended to normalize blood pressure and the cure of the main disease. Apply diuretics from the group of thiazide. The doctor also assigns alpha-adrenoblastors (propranolol). Inhibitors of angiotensin gluttering factors (Ramipril, Captopril). Immediately operate and prazosin operate.

If a drug approach does not help, then apply operational techniques

Surgical methods include balloral angioplasty, at which the intravascular blowing of the narrowed elements is carried out. The indication to such a method will be fibromy dysplasia, atherosclerotic damage to the renal artery. In such a vessel put a stent to warn relapse. When the balloon angioplasty does not bring relief, the doctor may assign an open operation. Such a type of therapy is preferable and with a severe degree of narrowing, with problems in the field of revealing the artery of the kidney.

Atherosclerosis in the vascular wall is removed by endarterectomy (eliminating the inner shell of the artery with an atherosclerotic bottle through the artery).

In the event that hypertension led to the deficiency of the kidneys, hemodialysis is needed, between the procedures of which hypotensive and immox-corrective therapy are appointed.

When omitting, nephropsychia needs. Nephroctomy is carried out only in the most extreme cases. Subsequently, the transplant of this body will be needed. It is important to know that if the cause of the disease became inflammatory processThe patient should use medicines having an antibacterial, anti-inflammatory effect. Sometimes the cause is the concrections that disturb the blood flow. In this situation, it is necessary to delete them by lipotripsy.

Differential diagnosis

It is necessary to conduct it with adrenal diseases. There are tumors of this organ, as a result of which the adrenal glands are isolated in blood catecholaminic compounds, thereby provoking hypertensive crisis. If high hell is accompanied by clear arrhythmia and an increase in thyroid hormones in the blood, then the cause lies in thyrotoxicosis.

The neoplasms of the cortical layer of adrenal glands are characterized, besides increasing blood pressure, the release of a large amount of urine, paralysis and paresis, concentration in the blood of aldosterone.

Distinctive signs of hypertension of renal origin and essential arterial hypertension

Preventive measures

Prevention consists in timely identification and full cure of renal pathology, as well as compliance healthy image Life. The seriousness of this ailment leaves no doubt. That is why in the absence of success from the treatment of hypertension, attention should be switched to the state of the kidneys.

Renal hypertension is a violation of the functioning of the kidneys associated with blood delay, sodium particles in vessels, the development of diseases. This pathology is diagnosed in many patients who come to a doctor with complaints on high blood pressure. Renal hypertension often develops at a young age. In order to prevent the onset of complications, it is necessary to diagnose the ailment when the first symptoms appear, carry out a complex and long-term treatment.

This disease is manifested in various impaired kidney function. These organs perform a number of important functions in the body: blood filtering, fluid output, sodium, various decay products. If the functioning of the organs is broken, the liquid and sodium are delayed inside, which is why edema appears throughout the body. The amount of sodium ions increases in the blood, which negatively affects the structure of vascular walls.

Damage to kidney receptors provokes increased rhenin products, which is later converted to aldosterone. This substance helps to increase the tone of vascular walls, reduce the lumen in them, which increases the pressure. As a result, the process of producing a substance that reduces the tone of the arteries is reduced, which causes even greater irritation of receptors. Due to a number of disorders, patients suffer from a constant increase in blood pressure in the kidneys.

The reasons

There are 2 varieties of renal hypertension:

1. Vasorenal hypertension.
2. Hypertension, developing as a result of damage to the kidneys of diffuse character.

Vasorenal hypertension is a disease provoking the emergence of the mass of disorders of the functioning of the renal arteries. These deviations arise as a result of pathologies in the work of vessels that appear both in congenital and for acquired reasons.

Disorders developed in the intrauterine period:

1. The growth of the walls of the renal artery.
2. The narrowing of the aortic is aortic.
3. Aneurysm artery.

Causes of renal hypertension acquired during life:

1. Atherosclerosis of renal vessels.
2. Burning renal artery.
3. Sclerosing panefritis.
4. Artery compression.

If there are pathologies in the work of the kidney in most cases, it is renovascular hypertension. In children, this disease in renal hypertension is detected in 90% of cases, in an adult less often.

Hypertension caused by diffuse kidney tissue damage develops as a result of various structural disorders in organs. There are strong pressure jumps.

Congenital causes of diffuse disorders of the kidney structure:

1. Insufficient kidney size.
2. Doubling organ.
3. The development of cysts.

Inflammatory processes in the tissues:

1. Pyelonephritis.
2. Glomerulonephritis.

Symptoms

Renal hypertension has characteristic signs similar to the heart of the form of this disease. Patients detect symptoms characteristic of typical kidney disease. There are benign and malignant variants of the flow, the symptoms of which are significantly different.

Benign renal hypertension

This form of renal hypertension is characterized. chronic flow. Constantly increased pressure, which is practically not reduced. There are no sharp pressure jumps. The patient complains on headache, constant weakness, dizziness appearance, frequent attacks of shortness of breath. In some cases, the brain activity is violated, which develops anxiety attacks. Additionally, painful heart abbreviations are accelerated by painful syndrome.

Malignant renal hypertension

Characterized by a rapid flow. A significant increase in diastolic pressure is diagnosed. The difference between indicators is constantly decreasing. The structural lesions of the visual nerve are diagnosed, which is why the appearance of irreversible violations of vision is possible. The patient complains about the appearance of sharp headaches that are almost impossible to stop. The most common localization of pain is observed in the occipital share. Also possible is permanent nausea, vomit attacks, dizziness.

General symptoms

Increased renal pressure not only has a number of specific features, but also characterized by common symptoms affecting the patient's well-being. If you pay attention to these features, you can exclude the occurrence of cardiac hypertension.

To find the appropriate treatment of renal hypertension, the disease should be diagnosed, revealing the following symptoms:

1. The appearance of sudden pressure jumps that are not preceded by stressful load and physical workouts.
2. The disease develops not only in old age, but also in people who were 30 years old or less.
3. Nearest relatives do not suffer from manifestations of hypertension, also do not complain about violations of the heart.
4. Together with other violations there is a painful syndrome in the lower back.
5. Events of the limbs appear, which are difficult to remove with drugs or distributed folk remedies.

Complications

When the renal hypertension appears, there is a risk of developing complications, which primarily affect the heart and brain. Basic complications arising in the absence of proper treatment of this disease:

1. Insufficiency of kidney and heart activities.
2. Brain circulation pathology.
3. The presence of hemorrhages in the retina.
4. Violations in the structure of arteries and large vessels.
5. Lipid metology.

There is a possibility of severe concomitant diseases characteristic dangerous consequences. With a constant increase in renal pressure, a loss of vision is possible, the development of atherosclerosis. There may be a stroke and heart attacks. Increased pressure is hazardous for kidney activities, there is a risk of their complete failure.

Diagnostics

To identify the renal hypertension in the initial stages can doctors with extensive experience. Qualified specialists have the opportunity not only to diagnose the syndrome of renal arterial hypertension, but also to choose a complex of drug events that will be able to remove the main symptoms of the disease, stop pressure jumps.

To spend differential diagnosis Renal hypertension, it is necessary to carry out permanent control over the pressure level over a long period of time. If for 30 days when measuring the pressure, an indicator of 140/90 mm RT is detected. Art., The diagnosis is confirmed. In the presence of pronounced pathologies in the kidney activities, kidney hypertension is diagnosed. When a disease is detected, a comprehensive treatment of renal hypertension is necessary.

To confirm the diagnosis, these studies are held:

1. Analysis of urine.
2. Ultrasound kidneys.
3. Urography.
4. Scintigraphy.
5. Angiography.
6. MRI and CT.
7. Biopsy.

Treatment

To reduce the renal pressure, you need to turn to the urologist and therapist. The doctor will appoint a set of activities that will help restore the kidney functions, as well as lower blood pressure. To eliminate existing disorders, surgical methods of correction are used, as well as use effective medicines.

Surgical intervention and procedures

In the diagnosis of congenital violations that provoke pressure lifting in the body, a planned operation is carried out. When blocking large vessels, the stenosis of the arteries is also a decision on conducting a surgical operation or the relevant procedure.

Balloon angioplasty is one of the most popular types of operation for the correction of acquired disorders provoked renal hypertension. In the course of its implementation, the enlightement of the vessels is expanded, correction of the structure of vascular walls. A special tube is used, which is entered into the affected area. This type of surgical intervention is carried out with full or partial conservation by the kidney of its functions. If a complete loss of functionality occurs, the organ removes.

For the correction of pathologies in the kidney structure, procedures are applied that do not provide surgical intervention. Food is used, in which the effects on kidney tissue is carried out using vibroacoustic waves. Due to moderate vibration, the composition of the blood is normalized, atherosclerotic plaques are eliminated. As a result, it is possible to significantly reduce pressure indicators, reduce the risk of blockage of the arteries.

Medical therapy

Renal arterial hypertension is eliminated when using drugs that reduce the symptoms of the progression of the underlying disease. In most cases, drug correction methods are used in the presence of inflammatory kidney processes. Often, the purpose of medication therapy is to reduce Renin production.

In order to reduce the pressure level as soon as possible, using ACE inhibitors, such as fozininryl, enalapril, captopril. For optimal selection of medicines, consultation with the attending physician is required. Sometimes used folk Methods Correction of disorders. Applied herbal fees, Various decoctions. The regular use of freshly squeezed juices is shown.

To fully cure the renal hypertension, it is necessary to combine medication therapy with folk remedies. You should also change the lifestyle, revise the diet. It is advisable to abandon saved or digested food. Exclude black coffee and alcoholic beverages. For the patient, a sore diet is chosen, a list is assigned. exercise. If used complex medical methods, You can cure the disease, eliminate the risk of recurrence.

Stable high blood pressure on the background various diseases The kidneys is a dangerous state for both health and life, and requires immediate medical intervention. Early diagnosis Renal hypertension and determination of the optimal timely course of treatment will help to avoid many negative consequences.

Renal hypertension (renal pressure, renal hypertension) refer to a group of symptomatic (secondary) hypertension. This type of arterial hypertension is developing due to certain kidney disease. It is important to correctly diagnose the disease and take on time all the necessary medical measures in order to prevent complications.

Renal hypertension is diagnosed about 5-10 cases from each 100 in patients with signs of stable hypertension.

Characteristic signs

Like a different type of disease, this pathology is accompanied by a significant increase in blood pressure indicators (starting from 140/90 mm Hg. Art.)

Additional signs:

• Stable high indicator diastolic pressure.
• Lack of age limitations.
• High risk of acquiring hypertension of malignant character.
• Difficulties in treatment.

Renal hypertension. Principles of classification of the disease

For practical use in medicine, a convenient classification of the disease has been developed.

Reference. Since hypertension is very multiple pathology, it is customary to use the classifications of the disease, in which one or group of existing criteria is taken into account. Diagnose a specific type of disease - a priority task. Without such actions, there is no choice of competent correct tactics of therapy and the designation of prevention measures. Therefore, doctors determine the type of hypertension for reasons that caused the disease, according to the features of the flow, specific indicators of blood pressure, the possible affix of the target organ, the presence of hypertensive crises, as well as the diagnosis of primary or essential hypertension, which is allocated to a separate group.

It is impossible to establish a type of disease yourself! Appeal to a specialist and the passage of complex comprehensive surveys is required for all patients.

Treatment with homework in case of any manifestation of blood pressure (episodic, and even more so - regular character) - unacceptable!

Renal hypertension. Principles of classification of the disease

Group of renoparshimatous hypertension

The disease is formed as a complication of certain types of functional renal disorders. It is about unilaterally or bilateral diffuse damage to the tissues of this important organ.

A list of renal lesions that may cause renal hypertension:

• Inflammation of some sections of renal tissue.
• Polycystic kidney, as well as other congenital forms of their anomalies.
• Diabetic glomerosclerosis, as a severe form of microangiopathy.
• Dangerous inflammatory process with localization in the glomerular renal apparatus.
• Infectious damage (tuberculosis nature).
• Some diffuse pathologies flowing along the type of glomerulonephritis.

The cause of the parenchymal type of hypertension in some cases is also:

• inflammatory processes in ureters or in urethra;
• stones (in kidneys and urinary tracts);
• autoimmune damage to kidney glomers;
• mechanical obstacles (in view of the presence of tumors, cysts and adhesions in patients).

Group of renovascular hypertension

Pathology is formed due to certain lesions in one or two renal arteries. The disease is considered rare. Statistics confirms only one case of renovascular hypertension from one hundred manifestations of arterial hypertension.

Provoking factors

You should fear:

• atherosclerotic lesions with localization in renal vessels (most frequent manifestations in this group of pathologies);
• fibromed hyperplasia of renal arteries;
• anomalies in renal arteries;
• mechanical squeezing

Group of mixed renal hypertension

As a direct reason for the development of this type of medical disease, physicians are often diagnosed:

• nephroptosis;
• tumors;
• cysts;
• congenital anomalies in the kidney themselves or vessels in this organ.

Pathology is manifested as a negative synergistic effect from a combination of damage to tissue and kidney vessels.

Group of mixed renal hypertension

Conditions for the development of renal pressure

Studying development process different species Renal hypertension, scientists have allocated three main factors of influence, this is:

• insufficient sodium ion renovation, leading to water delay;
• the process of suppressing the depressor system of the kidneys;
• activation of the hormonal system regulating blood pressure and blood volume in vessels.

Pathogenesis of renal hypertension

Problems occur when the renal blood flow decreases significantly and the productivity of glomerular filtration is reduced. This is possible due to what happens diffuse changes Parenhima or kidney blood vessels are affected.

How do kidney react to the process of reducing blood flow in them?

1. There is an increase in the level of reabsorption (the process of reverse absorption) sodium, which then becomes the cause of the same process and with respect to fluid.
2. But the pathological processes of sodium and water delay is not limited. Begins to increase in the volume of extracellular liquid and compensatory hypervolemia (a condition at which the blood volume increases by plasma).
3. Further development scheme includes raising the amount of sodium in the walls blood vesselsIn view of this swelling, while showing increased sensitivity to angiotensin and aldosterone (hormones, water and salt metabolism regulators).

Why increase pressure in some kidney pathologies?

It should also be mentioned about the activation of the hormonal system, which becomes an important link in the development of renal hypertension.

The kidneys allocate a special enzyme called Renin. This enzyme contributes to the transformation of angiotensinogen in angiotensin I, from which, in turn, angiotensin II is formed, which narrows vessels and increases blood pressure. .

Development of renal hypertension

Effects

The above-described blood pressure increase algorithm is accompanied by a gradual decrease in the compensatory kidney capabilities, which were previously aimed at a decrease in blood pressure if necessary. For this, the selection of prostaglandins (hormone-like substances) and KKS (Kallikrein-Kininovaya system) activated.

Based on the foregoing, it is possible to make an important conclusion - renal hypertension develops on the principle of a closed vicious circle. At the same time, a number of pathogenic factors lead to renal hypertension with a persistent increase in blood pressure.

Renal hypertension. Symptomatics

Renal hypertension. Symptomatics

Diagnosis of renal hypertension should be taken into account the specifics of such concomitant diseases as:

• pyelonephritis;
• glomerulonephritis;
• diabetes.

Pay attention to a number of such frequent patient complaints like:

• pain and uncomfortable feelings in the lower back;
• problems with urination, increased urine volume;
• periodic and short-term increase in body temperature;
• stable feeling of thirst;
• feeling of constant weakness, decline forces;
• swelling of the face;
• macrohematuria (visible bleeding of blood in the urine);
• fast fatiguability.

In the presence of renal hypertension in the urine of patients, they often detect (during laboratory tests):

• bacteriuria;
• proteinuria;
• microhematuria.

Typical features of a clinical picture of renal hypertension

Typical traits clinical picture Renal hypertension

The clinical picture depends:

• from specific blood pressure indicators;
• kidney functional abilities;
• the presence or absence of concomitant diseases and complications affecting the heart, vessels, brain, etc.

Renal hypertension is invariably accompanied by a constant increase in the level of blood pressure (with the dominance of increasing diastolic pressure).

Patients should seriously fear the development of malignant hypertensive syndrome, accompanied by arteriole spasms and an increase in the overall peripheral resistance of the vessels.

Renal hypertension and its diagnosis

Renal hypertension and its diagnosis

The diagnosis is based on the symptoms of concomitant diseases and complications. For the purpose of differential analysis are necessarily held laboratory methods Research.

Renal hypertension and its diagnosis

Patient can assign:

• OAM (urine analysis General);
• urine analysis in Nechiphenko;
• urine analysis in winter;
• Ultrasound kidneys;
• bacterioscopy of blades;
• excretory urography (x-ray method);
• scanning of the kidneys;
• radioisotope renography (X-ray examination with the help of a radioisotope marker);
• kidney biopsy.

The conclusion is a doctor according to the results of a patient's survey (collection of anamnesis), its external inspection and all laboratory and hardware research.

Treatment of renal hypertension

The course of the treatment of renal hypertension must necessarily include a number of medical measures to normalize blood pressure. At the same time carried out pathogenetic therapy (The task is the correction of violated functions of the organs) of the main pathology.

One of the main conditions for effective assistance to nephrological patients is an ingredient diet.

What does this mean in practice?

Attention! The patient should not consume salt more by allowing him the norms of five grams per day. Keep in mind that sodium is also contained in most products, including their flour products, sausage products, conservation, so from the caring of the cooked food will have to be abandoned at all.

Treatment of renal hypertension

In which cases is allowed tolerant salt regime?

Slightly increase sodium consumption is allowed to be allowed to be prescribed as a medicine solheretics (thiazide and loop diuretics).

It is not necessary to strongly limit salt consumption to patients with symptomatics:

• polycystic kidney;
• sollying pyelonephritis;
• some forms are chronic renal failure, in the absence of a sodium excavation barrier.

Diuretics (diuretic)

Classification of contemporary diuretic drugs (diuretics) according to the following therapeutic effect

Note. To determine the individual salt regime, the daily separation of electrolytes is determined. It is also necessary to fix the surrounding indicators of blood circulation.

Three main rules for therapy for renal hypertension

Studies conducted in the development of various techniques to reduce blood pressure during renal hypertension showed:

1. A sharp decrease in blood pressure is unacceptable due to the significant risk of violation of the functionality of the kidneys. The initial level should not be lowered more than one quarter at a time.
2. Treatment of hypertensive with the presence of pathologies in the kidneys should be sent primarily to the decrease in blood pressure to an acceptable level even on the background of a temporary decrease in kidney performance. It is important to eliminate systemic conditions for hypertension and non-immune factors worsening the dynamics of renal failure. The second stage of treatment - medical Helpaimed at strengthening renal functions.
3. Arterial hypertension in a mildly implies the need for stable hypotensive therapy, which is directed to the creation of positive hemodynamics and the creation of barriers to the development of renal failure.

Medicinal preparations for reducing blood pressure during renal failure

The patient can assign a course of thiazid diuretics, in combination with a number of adrenoblastors.

To combat nephrogenic arterial hypertension The use of several different hypotensive drugs is allowed.

Pathology is treated:

• inhibitors of angiotensin-converting enzyme;
• calcium antagonists;
• b-blockers;
• diuretic means;
• a-blockers.

Medicinal preparations for reducing blood pressure during renal failure

Therapeutic process must comply with the principles:

• continuity;
• high time duration;
• nutrition restrictions (special diets).

Determination of the severity of renal failure - an important factor

Before appointing specific drugs, it is necessary to determine how much renal failure is expressed (the level of glomerular filtration is investigated).

Duration of drug reception

The patient is determined for a long taking a specific type of a hypotensive drug (for example, driving). This drug affects brain structures regulating blood pressure.

Duration of drug reception

Terminal stage of renal failure. Features of therapy

Conducting chronic hemodialysis. The procedure is combined with hypotensive treatment, which is based on the use of special medicines.

Important. With ineffectiveness conservative treatment and the progression of renal failure single way out - Donor kidney transplantation.

Preventive measures for renal hypertension

In order to prevent renal arterial origin, it is important to observe simple, but effective, precautions:

• systematically measure blood pressure;
• at the first signs of hypertension to seek medical care;
• limit salt consumption;
• ensure that obesity does not develop;
• abandon all bad habits;
• lead a healthy way of life;
• avoid hypoints;
• pay sufficient attention to sports and exercise.

Preventive measures With renal hypertension

conclusions

Arterial hypertension is considered a cunning disease that can cause the emergence of various complications. In combination with the damage to the kidney tissue or vessels, it becomes deadly. Reduce the risk of pathology will help careful compliance with prevention measures and consultation from medical professionals. It is possible to do everything possible to prevent the occurrence of renal hypertension, and not to deal with its consequences.

Renal hypertension develops in people with kidney diseases when an increased blood pressure over a long time is observed. With long-term treatment and observation, the doctor normalizes the pressure due to the restoration of the functionality of the kidneys.

General characteristics of pathology

Among hypertensive in 10% of patients, the pressure jumps are caused by a violation of the work of the kidneys. In the risk group, people with diseases of the urogenital system, in most men older than 30 years old. When measuring the indicators above the norm, both the upper (systolic) and the lower (diastolic) pressure are turned out.

The kidneys are engaged in blood filtering, regulate the volume of fluid in the body, remove excess, sodium ions and cell life products. Due to the push of blood from the heart there is a powerful flow into the periphery, and when the heart muscle relaxes, the blood returns back. At this point, filtering through the renal gloves. Nephrogenic hypertension originates at the moment of deterioration of blood flow in kidneys and glomerular dysfunction.

The body detains the withdrawal of sodium salts and fluids, the edema of tissues appears, thicken the walls of the vessels, and due to the oversofty of the enzymes allocated in the arteries, sclerotic plaques appear, narrowing the lumen of the vessels. The return of blood to the heart weakens, the tone of the vessels deteriorates, as a result of which the blood pressure increases and remains on high level. Long fastening at elevated marks (more than 140/90 mm Hg. Art.) Leads to violations of work of cardio-vascular system And to more serious complications.

Causes of the disease

The root cause of the development of kidney pathology, contributing to the increase in blood pressure to the nephrogenic type of hypertension, are:

• anomalous structure of the kidneys: organs that have not grown to normal volume, doubled;
• inflammation in tissues - diagnosed previously pyelonephritis and other kidney disease.

Specialists share the causes of vase renal pressures (vascular disease) on acquired during life and congenital. To the second type belongs:

• pathological narrowing of renal arteries;
• the alternation of the lumen of the aorta or complete obstruction (when the tissues of the walls of the vessels are overgrown).

Acquired causes of progressive renal hypertension:

• nephropathy arising after the developed diabetes;
• atrophy of kidney tissues as a result of age-related changes;
• urolithiasis;
• the appearance of the compaction of the fibrous capsule organ.

The development of renal failure contributes to the rapid appearance of renal hypertension. In this case, the negligence attitude towards well-being and the lack of drug treatment leads to a fatal outcome. At first symptoms, you need to consult a doctor for the direction of examination and to nephrologist.

In addition to the above, the reasons for increasing renal pressures may be such diseases:

• system red lupus;
• diabetic destruction of the body;
• sclerodermia;
• liver disease;
• classical hypertension.

Symptoms of renal hypertension

Pathology is characterized by such symptoms:

• increased renal and heart pressure, occasionally rises only kidney;
• increased fatigue without visible reasons;
• retinal lesions of the eye with hemorrhages and swelling of the optic nerve, the appearance of black "flies", defocusing;
• empty of the limbs, soreness lumbar Department;
• anomalous sharp increase in pressure.

During the examination of the patient, noises are found in the kidney arteries in the zone above the navel and from the lower back. Additionally, asymmetric data appear when measuring pressure on different limbs, changes chemical composition Urine - protein content, lowering its density.

There are differences between the clinical picture malignant and benign renal hypertension:

• In the case of a malignant form, the disease develops instantly: the lower pressure can take off to 119 mm Hg. Art. And practically levels with the top. Amazed speed \u200b\u200bnerve, headaches begin in the occipital zone.
• With benign hypertension, the disease develops slowly. An uniform increase in pressure, which is not declining after the reception of medicines is noted. Patients suffer from pain in the frontal part, feel weakness, shortness of breath. The heart accelerates the rhythm, the patient feels pulsation and pain in the left chest.

Diagnostation

To identify the renal hypertension will not work independently - to clarify the reasons for the appearance of pathology, the therapist is needed. It must select a large number of reasons similar in symptoms provoking renal pressure growth.

The diagnosis of an atypical increase in diastolic pressure begins with constant control over the pressure level during a long period of time. If during the month the patient was noted signs of hypertension, and the pressure was stably elevated (not lower than 140/90), then pathology is present. The presence of tangible failures in the work of the kidney determines the secondary hypertension, to prevent irreversible consequences, the doctor prescribes a complex treatment immediately.

For accurate determination of pathology, patients undergo such studies:

• general blood analysis;
• urine analysis: In the surface, proteins appear in the urine;
• angiography of renal vessels;
• Ultrasound of affected kidney and large vessels;
• urography to assess the state urinary tract;
• biopsy;
• MRI and tomography of kidney vessels;
• dynamic scintigraphy.

Treatment of renal pressure

Treatment involves the production of two tasks:

• restoration of kidney performance, urinary system;
• therapy eliminating the causes of the advent of renal hypertension.

At home to downgrade high pressure It may be difficult, so the doctor prescribes a complex reception of drugs. Depending on the severity of the disease, the doctor prescribes medicines from groups:

• terminating the reabsorption of salts and liquid and accelerating their excretion with urine;
• substances lowering calcium suction to reduce the muscle tension of the heart;
• aPF inhibitorsblocking the enzymes of the body causing hypertension;
• beta blockers.

In comprehensive treatment, the hardware of the physics procedure is used. The patient is applied to the nozzles of the device of vibroacupustics, helping to accelerate the removal of urinary acid from the body, stabilize the work of the kidneys and restore pressure.

In severe stages of the disease, when folk remedies are not effective, and side symptoms from tablets may irreparable to harm the body, the doctor makes a decision on surgical intervention. The operation is carried out in identifying polycystic, oncological neoplasms and congenital kidney abnormalities.

If the narrowing of the adrenal artery is detected, the patient is prescribed a balloon angioplasty. Occasionally, with strong lesions of the kidney vessels, the surgeon decides to carry out nephrectomy - kidney removal. This happens when the disease is running, when the risk of life appears.

Doctors confirm that kidney hypertension can be cured, complementing drug therapy by folk remedies:

• the infusion of tolnaya lowers the diastolic pressure;
• the use of dill seed cleans the kidney vessels;
• collection of birch leaves, wild pear, Rhines and the gold male reduces inflammation.

Each recipe must first be coordinated with a specialist.

Comprehensive treatment renal hypertension under the supervision of the doctor should be complemented by a strict diet with increased content , minimizing the amount of salt consumed, refusal from and increasing physical Loads. This will help reduce the renal pressure and avoid irreversible complications to people with severe forms of the disease.

Forecast

Lack of treatment and pulling the campaign to the doctor provoke the transition of pathology in chronic formcapable of imparting irreparable harm to internal organs, and even lead to a fatal outcome.

Renal hypertension can cause the development of such diseases:

• renal and heart failure;
• brain circulation disorders;
• eye hemorrhage;
• impairment of vision;
• irreversible deformations of large vessels;
• violation of metabolism.

Violation of blood flow, constantly increased pressure and damage of vessels leads to dysfunction internal organs and all vital systems. However timely treatment and discovery pathology on early stages possibly full cure From the illness and restoration of the affected organs and blood vessels.

Video about renal hypertension

The frequency of development, reasons, symptoms and treatment of pathology is described in this television:

Preventive measures

To protect against disrupting the kidney and cardiovascular system, it is required:

• monitor the pressure level when poor well-being appeared;
• when measuring the pressure and fixation of the increase over the course of several days, immediately consult a doctor;
• exclude from the diet harmful to kidney receptors Products: sharp, roasted, smoked, fat;
• salt use to cut to 3 g per day and less;
• leave bad habits;
• observe the correct mode of the day and sleep, fully utilized (especially in the presence of diseases of the cardiovascular system);
• to engage in moderate physical education and sports to strengthen the body, muscle tone and immunity, while it is important not to overdo it and monitor well-being during training;

IN folk medicine There are proven recipes to protect against the symptoms of renal hypertension. Need:

• every day, use a teaspoon of fish oil and add dishes from fish fatty varieties into the diet;
• add garlic and onions in the process of cooking dishes, as well as there are them in raw form as a vitamin and immunostimulating supplement;
• make a wellness drink from kefir with greens or garlic (you can replace the ingredients or supplement sea cabbage), take 1 glass a day before meals;
• drink fresh vegetable juices, especially useful juice from celery, carrots and beets;
• in therapeutic doses to add to tea or drinking in the undiluted form of the infusion of a hawthorn.

A trip to the doctor immediately after the appearance of symptoms often helps to identify other serious kidney pathologies and proceed to their treatment. It is important to realize that many people have problems with arterial pressure Due to improper lifestyle and nutrition. Combination of lifestyle correction with competent medical treatment It guarantees complete cure from renal hypertension.

Another dangerous disease associated with pressure - biliary or bile hypertension is dangerous diseaseassociated with the occurrence of deviations from normal blood pressure.

The article covers the issues of origin of pathology, what it is and how it is treated.

General characteristics of the disease

Bilyary hypertension is difficult to diagnose liver and gallbladder disease.

Her nature is to increase the pressure of bile on the walls of biliary ducts and gallbladder, that is, on the hepatobiliary system.

The high database speaks of the difficult-to-bile bile from the liver in the duodenum.

The mandatory consequence of pathology is a violation of digestion and pain in the right-hand.

The disease develops for several reasons:

1. Tumors. Malignant or benign formations squeeze intrahepatic ducts or biliary paths. They can grow on the liver or nearby organs, such as pancreas. Similarly affect the tumor-like formation (cyst of the pancreas and others). Currently, oncology is the cause of half of the cases.
2. Gallgame cholecystitis. If the stones fall at the mouth of the gallbladder, this syndrome develops.
3. Helmintosis. Some types of helminths are capable of surviving in a biliary medium, such as opistores and echinococci.
4. Polyps. The growth of polyps in the biliary system blocks metabolic processes similar to gallstones.
5. Congenital pathology. Changing the diameter of the ducts of the hepatobiliary system. Diagnosed at an early age.

Due to functional

military changes of the affected organs are disturbed by blood circulation in the affected and adjacent organ, local hypertension appears.

The nature of blood pressure changes in veins and arteries speaks of the location of malignant neoplasms.

The ICD provides such types of biliary hypertension:

• intrahechen - appears due to blocking portal liver veins;
• guidance - the result of complicating blood flow in vessels supplying the liver;
• post-secret - with a violation of blood outflow into a hollow vein;
• mixed - a combination of several species described.

There are several stages BG:

1. Initial - iron works properly, but with a low-speed slowdown.
2. Moderate - stagnation of bile in ducts, in which it is possible to compensate for the malfunction.
3. Pronounced - characterized by the accumulation of fluid and an increase in the abdominal cavity.
4. Complicated - fraught with the possibility of internal bleeding and disruption of the kidneys.

Unfortunately, initial stage BG is poorly expressed, it is easy to confuse with other diseases. In most cases, the disease is detected on moderate, more often expressed phase.

Symptoms of illness in the early stages

Calculate biliary hypertension in symptoms is not impossible.

The disease hides under other disorders of digestion, and the patient is always deceived by buying unnecessary drugs.

Especially often undigested with poisoning. At the same time, pathology continues to progress and give more unequivocal signs. Only at this stage there is an appeal to specialists, a medical examination is the only way to reveal BG for sure.

Signs of biliary hypertension at an early stage:

• chronic fatigue and sleep disorders;
• flatulence;
• bloating;
• colic in stomach;
• unstable stool;
• express, vomiting and nausea.

In the later stages of BG to the listed symptoms added:

1. an unpleasant taste in the mouth;
2. anemia;
3. sharp weight loss;
4. jaundice.

To consult a doctor makes the ethimic-ascitic syndrome, it can develop in a few weeks or months and result in an increase in abdomen, shortness of breath and meteorism. It is the consequence of the accumulation of ascitic fluid in the abdominal cavity.

Also can swollen legs in the ankle. In the later stages of the disease, Vienna scatter on their feet.

Bful hypertension can be detected by an enlarged spleen. Changes in the form are due to the deterioration of the composition of the blood, staging in it of some elements. This phenomenon contributes to the development of anemia and some other diseases.

Symptoms of launched form

The most clearly expressed symptom of BG is a mechanical jaundice. It also appears in the late stages of the development of the disease and explicitly indicates problems with bubble. On the one hand, it gives the skin and a gall-colored mucosa, on the other, it causes periodic itching. The latter is caused by irritation of peripheral nerves with bile acid, which enters the blood and applies throughout the body.

If you diligently ignore the symptoms of the disease, it manifests itself much tougher.

Unambiguous sign of the launched stage BG:

• internal bleeding;
• gastric spasms;
• bloody vomiting;
• blood plugs in feces.

It is important that internal bleeding always appears unexpectedly and painlessly. Blood emissions are not limited to stop them hard. Thus, the disease is deadly.

As mentioned, the pathology under consideration is hard in discovery in the early stages. Moreover, even the doctor cannot confirm the diagnosis until the results recognize the results. To identify BG, it is necessary to conduct a survey by various methods.

The choice of diagnostic techniques depends on the complexity of the course of the ailment and the available technical capabilities of a medical institution.

Diagnosis of pathological disorder

In this case, various can be appointed clinical researchesDepending on the complexity of the disease.

They can be divided into two groups:

1. Invasive - Methods based on the introduction of special substances in the body or its cavity (X-ray-repeat studies, biopsy, laparoscopy).
2. Non-invasive methods are less accurate, but are carried out easier and faster (ultrasound, tomography).

Uzi is a non-invasive study of the human body with ultrasound waves. Due to simplicity and security, it is the most popular. Regular examination makes it possible to identify the disease on an early asymptomatic stage.

Computed tomography - the method of layer-by-layer tissue research using X-ray radiation. Allows you to more fully consider the structure and parameters of the neoplasms than the previous method. Its private case - MRI.

X-ray-contrast study is based on input in the cavity of the body of liquid contrasting substances. They repeat natural paths in the form and detect the plots in the picture, invisible by the usual x-ray. In addition, they reflect the passability of the ducts under consideration.

Biopsy differs from previous methods by what is carried out after the diagnosis is established. It is needed in order to understand the nature of malignant education. It is performed according to the following principle: a needle is introduced through the skin to the organ that removes the tissue portion. Monitoring the process is carried out using ultrasound. The material obtained is analyzed in the laboratory. This is the most accurate method for setting the final diagnosis and the possibility of removing the neoplasm.

Extreme case - laparoscopy. This is nothing more than surgery. It is used to visualize painful sections and the fence of materials for analyzes. Together with this, therapeutic manipulations may be produced depending on the nature of the disease.

Methods of treating disease

The nature of the treatment of biliary hypertension depends on the two conditions - the causes of pathology and the development stage of the disease.

Most cases require surgical intervention, but sometimes it can be avoided. If it is in oncological formations or polyps, operational and / or chemical therapy is needed. Breast disease is required to treat with drugs, if the nature of the accretions allows. Again, first of all it depends on their "age". For helminthosis of any stage, only conservative therapy applies.

The surgical treatment method necessarily takes place in the later stages of the disease, when symptoms are dominated - ascites and internal bleeding. In the case of BG, it always represents laparoscopy. Currently, there is enough technical means for carrying out neat and gentle operations. They are absolutely safe, require little time for recovery and is always more effective than self-medication attempts.

A specialist in the video in this article will tell how to deal with elevated arterial pressure.