Diagnosis of hypertensive nephropathy have?

Hypertensive nephropathy is life often appear a disease, if the patient suffers from hypertension, proteinuria appeared after a long period, indicating that you have high blood pressure kidney disease, many patients and their families are very concerned about the treatment of the problem of hypertension in should be carried out before the diagnosis of hypertensive renal disease treatment, so that patients do early detection, early examination, early treatment. Can effectively avoid the deterioration of the patient.
Diagnosis of hypertensive nephropathy have?
A medical history and symptoms
Over the age of 40-50 years of age, history of hypertension over 5-10 years. Early only nocturia, followed proteinuria, individual cases may be due to broken capillaries transient hematuria occurred, but not with significant low back pain. Often associated with arteriosclerotic retinopathy, left ventricular hypertrophy, coronary heart disease, heart failure, cerebral arteriosclerosis and (or) history of cerebrovascular accident. Slow progression, gradually developed into a small part of renal failure, most perennial mild renal impairment and abnormal urine. Malignant hypertension diastolic take more than 16Kpa (120mmHg), accompanied by significant and rapid development of cardiovascular and cerebrovascular complications, proteinuria, often accompanied by hematuria, renal function decline.
Second, the examination found
General persistent elevated blood pressure (20.0 / 13Kpa, 150 / 100mmHg or more); Some of the eyelids and / or lower extremity edema, heart community to expand, etc.; most arteriosclerotic retinopathy, when the fundus stripes, flame-shaped hemorrhage and cotton wool soft exudates, supporting the diagnosis of malignant renal atherosclerosis. With hypertensive encephalopathy may have a position corresponding neurological signs.
Third, laboratory examinations
(A) mostly mild to moderate proteinuria, 24 hours more in quantitative 1.5 ~ 2.0g; microscopic physical components (red blood cells, white blood cells, transparent tube type) less, may have hematuria; early serum uric acid, urine NAG enzyme , β2-MG increased urine concentration - diluted dysfunction; Ccr much slow decline, blood urea nitrogen, creatinine increased. Renal tubular dysfunction much earlier than glomerular dysfunction.
(B) imaging of renal much change, development-induced renal failure occurs when the kidneys can be reduced to varying degrees; radionuclide appears early detection of renal damage; ECG left ventricular often prompts high voltage; chest X-ray or echocardiogram often Tip primary atherosclerosis, left ventricular hypertrophy, or enlarged.
(C) difficulties in the early diagnosis of renal biopsy should be made.
Fourth, the differential diagnosis
A variety of secondary hypertension should be the exception, especially chronic nephritis hypertension type. Malignant renal atherosclerosis should be rapidly progressive glomerulonephritis, systemic vasculitis disease phase identification.