HTN, Diabetes and the Kidney (1)

Question 1

Hypertensive Nephropathy:
How does HTN lead to CKD?

What is seen on USS?

Answer 1

➊ Progressive hyaline arteriosclerosis in renal arteries causing chronic and progressive renal ischaemia → Tubular atrophy, interstitial fibrosis, and glomerular sclerosis → Progressive CKD

➋ Small, fibrotic kidneys

Question 2

Diabetic Nephropathy:
What does it start with?
→ What is seen on investigations?
→ What should all pts with this be started on?

What does it end with?

Answer 2

➊ Microalbuminuria
→ Raised ACR - > 2.5 in men or > 3.5 in women
→ ACEi

➋ Proteinuria as a sign of kidney failure