Hypertensive Nephrosclerosis

Question 1

T/f HTNN presents with albuminuria

Answer 1

false. GFR falls but no albuminuria. can help you differentiate it from diabetic nephropathy

Question 2

biggest risk factor of HTNN

Answer 2

hypertension biggest risk factor. damages the microvasculature of the kidneys directly.

Question 3

afferent arteriole is thickened with hyaline, caused by damage from high blood pressure.

two big changes;

• glomeruli get shirvlleld up because of ischemia , and then get scarred. Scarring can be global or segmental.

Question 4

3 key characterizations of hypertensive nephrosclerosis

Answer 4

• pateitns must have risk factors
• characterized by:
  1. slow progression
  2. urine without protein or blood (would be a red flag)
  3. unremarkable imaging

Question 5

treatment of hypertensive neprhosclerosis

Answer 5

1. treat the hypertension
2. treat the cardiovascular risk factors

Question 6

what are the blood pressure targets in HTN Neph

Answer 6

140/90mmHg, less than 120 mmHg systolic

Question 7

what is considered “stage A3”

Answer 7

over 300mg albuminuia. if someone is in stage A3, consider another diafnosis

Question 8

T/F we should do a kkideny biopsy in HTNN

Answer 8

false. we usually don’t do it, but we might if there are suspiciouns for another disease process.

Question 9

When can you apply ACES and ARBS in HTN neph?

Answer 9

• stage A3 kidney disease
• diabetes/other cardiovascular risk factors.
• usually these meds are added as soon as someone is diagnosed with htn neph

Question 10

what kind of diet is useful in the managmenet of htnneph

Answer 10

DASH diet; low salt diet

Question 11

for vascular protection, what additioanl med should we apply to a management plan htn neph

Answer 11

STATINS for anyone over the age of 50 with CKD.

• also counsel smoking cessation

Question 12

T/F even with properly management htn neph, there is a high risk fo progression to kideny failure

Answer 12

false. excellend prognosis