Hypertension Effects

Question 1

D?

Answer 1

Hypertensive arteriolar nephrosclerosis is progressive kidney damage caused by long-standing, poorly controlled high blood pressure (hypertension).

Question 2

RF?

Answer 2

• Older
• Poorly controlled BP
• Kidney disorders
Black People

Question 3

ddx

Answer 3

• CKD
• Diabetic nephropathy
• Renal artery stenosis
• Renal artery stenosis
• Glomerulonephritis

Question 4

E?

Answer 4

Age: old
Sex:
Ethnicity: Black
P:

Question 5

A?

Answer 5

Hardening of renal arterioles causing increased pressure and damage to the nephrons.

Question 6

CP?

Answer 6

• Loss of appetite
• Nausea and Vomiting
• Itching
• Sleepiness/confusion
• Weight loss
• Unpleasant taste in mouth

Question 7

P?

Answer 7

• Pathophysiology: chronic hypertension→ narrowingofafferentarteriolesandefferent arterioles→ reductionofglomerularblood flow→glomerularand tubularischemia→ arteriolonephrosclerosisandfibrosis(focal segmental glomerulosclerosis)→end-stage renal disease

Question 8

Investigations?

Answer 8

• FBC and A:Cr show declining renal function
• Urinalysis-Initiallymicroalbuminuriaandmicrohematuria
• With disease progression, nephrosclerosis withmacroalbuminuria(usually< 1 g/day) and progressiverenal failureoccur.
Biopsy:sclerosisincapillarytufts,arterial hyalinosis

Question 9

Management?

Answer 9

• BP control

Question 10

Prognosis?

Answer 10

• Depends on BP control

After 5-10 yrs, 1-2% pts develop significant renal dysfunction

Question 11

Complications?

Answer 11

• End stage renal failure

CKD