Nephrogenic arterial hypertension( renal pressure) - Causes, symptoms and treatment. MF.

Nephrogenic arterial hypertension( or as patients call it - "renal" pressure) is a systematic increase in blood pressure due to kidney pathology. According to the mechanism of its development, nephrogenic arterial hypertension is vasorenal and parenchymal. At the first, the functioning of the vessels of the organ is disrupted, and for the second, it directly affects the tissues of the organ.

Causes of nephrogenic arterial hypertension

Regardless of the type of nephrogenic arterial hypertension, the mechanism of the development of the disease remains unified. When the function of the organ is impaired, the production of a special hormone - renin, which is responsible for the tonus of the vascular wall - increases. Raising the tone of the arteries, the renin narrows the lumen of the arteries, thus increasing blood pressure.

The direct cause of the of the vasorenal hypertension is the pathology of the renal vessels. First, it can be congenital anomalies, for example, hyperplasia of the walls of the renal artery, coarctation of the aorta or an aneurysm of the renal artery. In addition, the acquired factors can contribute to increasing blood pressure. Atherosclerosis of the kidney vessels, embolism of the renal artery, stenosis of the vessel, sclerosing paranephritis, compression of the renal artery from the outside - diseases that can also cause nephrogenic arterial hypertension.

As for of parenchymal arterial hypertension , its causes can also be both congenital and acquired factors. Among the developmental anomalies affecting the level of arterial pressure, it is necessary to note hypoplasia and kidney doubling. In addition, the cause of high blood pressure can be an innate variant of the kidney cyst.

Among the acquired causes of nephrogenic arterial hypertension, inflammatory diseases of the kidneys have the largest share. Acute and chronic pyelonephritis and glomerulonephritis are the most frequent causes of increased blood pressure due to a high concentration of renin in the blood.

The mechanism of development of a nephrogenic arterial hypertension

Diagnosis of a nephrogenic arterial hypertension

It is very difficult to diagnose a nephrogenic arterial hypertension, since it is necessary to exclude almost a dozen diseases that can also lead to an increase in blood pressure.

First, to presume a possible diagnosis, periodic monitoring of blood pressure at home with a tonometer is necessary. In this case, if within one month there is an increase in blood pressure above 140/90 mm Hg, then the diagnosis of hypertension is exposed. If in the course of further examination it is possible to reveal the pathology of the kidney, then the arterial hypertension is classified as nephrogenic.

For this, a whole list of studies is produced, in the first place in which there is a general analysis of blood and urine. Often, with inflammatory kidney disease, it is possible to detect an increased number of leukocytes in the blood and urine. In addition, with glomerulonephritis, a small amount of erythrocytes can be noted in the urine.

The next step in the diagnosis is the ultrasound of the kidneys, during which it is possible to detect abnormalities of development, cysts or neoplasms of the renal parenchyma.

ultrasound. Hydronephrosis as the cause of nephrogenic arterial hypertension

To determine the function of the kidneys, radioisotope renography or excretory urography is performed. These methods give an idea not about the structure of the body, but about its functional capabilities.

If at such a screening it is possible to determine the pathology of the kidneys, then a laboratory study is conducted to determine the level of renin in the blood. This method of diagnosis makes it possible to clearly judge whether the pathology of the kidneys affects the level of blood pressure or not.

Symptoms of nephrogenic arterial hypertension

In its clinical course, nephrogenic arterial hypertension is practically the same as hypertensive disease, although there are some features that allow nevertheless to establish the pathology of the kidneys.

There are two variants of the course of the disease: benign and malignant. In a benign variant of nephrogenic arterial hypertension, the pressure is usually increased stably and does not tend to decrease. Patients complain of headaches, weakness, dizziness, fatigue, dyspnea, discomfort and pain in the heart, as well as palpitations.

Malignant form of nephrogenic arterial hypertension is characterized by an increase, mainly, of diastolic pressure. A rapidly progressive process will soon cause a visual impairment, which is called hypertensive retinopathy. Patients with a similar course of the disease complain of persistent headaches, mainly in the nape of the neck, nausea, vomiting and dizziness.

Analyzing the symptoms of the disease, it can be noted that they practically do not differ from the signs of ordinary hypertension. But in some cases, because of the violation of renal circulation, patients can note pain in the lumbar region, which makes it possible to assume the presence of a urological disease.

If the patient has at least one of the above symptoms, you should immediately contact a urologist or therapist who can assign the right tests and studies to confirm or refute the diagnosis of a urological disease.

Treatment of nephrogenic arterial hypertension

At least two physicians - a urologist and a therapist - should participate in the therapy of this disease. If the first task is to cope with kidney disease, then the second is obliged to normalize the level of blood pressure.

Treatment of kidney disease depends on its type. For example, if a patient suffers from a tumor or a kidney cyst, then in this situation it is simply necessary to do without surgical intervention, during which it is necessary to remove the tumor.

In inflammatory processes of the renal pelvis or parenchyma, antibacterial drugs, such as ceftriaxone and gatifloxacin are prescribed. They can be purchased at the pharmacy without a doctor's prescription, only you do not need to do this, since these medicines have multiple side effects that should be controlled by a specialist.

The second direction in the treatment of nephrogenic arterial hypertension is the normalization of blood pressure. It can be produced by any antihypertensive drugs, but only angiotensin-converting factor inhibitors are pathogenetically conditioned. Representatives of this group are preparations of captopril, enalapril and fozinopril. They are released on the prescription of a doctor in almost any pharmacy. The course of treatment depends on blood pressure indicators, which should be normalized to numbers below 140/90 mm Hg.

Nutritional characteristics and lifestyle with nephrogenic hypertension

With arterial hypertension, regardless of its cause, a diet is prescribed with a restriction on the amount of dietary salt in the diet. In addition, it is necessary to exclude sour, fried, peppery and spicy dishes, which, in addition to increasing arterial pressure, negatively affect the function of the kidneys. Absolutely inadmissible at the raised arterial pressure the use of coffee, strong tea and alcoholic drinks is considered.

With regard to lifestyle, it must be remembered that with hypertension, including nephrogenic, it is necessary to avoid strong physical stress, which can contribute to an increase in the tone of blood vessels and, accordingly, blood pressure.

Rehabilitation after illness

Patients with nephrogenic arterial hypertension are recommended courses of sanatorium treatment in sanatoriums with coniferous and forest air. Excellent for this purpose are suitable health resorts Khmilnik, which specialize in the treatment of diseases of the cardiovascular system.

In addition, a whole set of exercises for therapeutic exercise, which contribute to reducing the tone of arterial blood vessels and lowering blood pressure, has been developed. However, before starting these procedures, you need to consult a physiotherapist in order to pick up the right physical activity.

Treatment of nephrogenic arterial hypertension with folk remedies

Traditional medicine is a huge amount of money for the treatment of hypertension. Some of them have a sufficiently powerful hypotensive effect, which in a number of cases gives positive results. The main mistake of folk treatment for nephrogenic arterial hypertension is that it acts not on the cause of the disease, but symptomatically lowers the pressure. In this case, the disease continues to progress, and after stopping the intake of tinctures or herbs, the pressure rises even more.

Thus, the use of folk remedies is only permissible if the cause of the disease is finally revealed, and it is not covered in kidney pathology.

Complications of nephrogenic arterial hypertension

With constantly high blood pressure, so-called target organs begin to suffer. First of all, the vascular system of the eye is disturbed, which leads to the appearance of hypertensive retinopathy. Patients begin to complain of a progressive visual impairment, which is irreversible.

In addition to the eyes, due to high blood pressure, the function of the brain and the heart muscle begins to break. Subsequently, it may threaten with a stroke or a heart attack.

In addition, with increased arterial pressure, the vascular system of the kidney itself begins to suffer. Thus, the "vicious circle" is obtained, which opens only after the kidney function completely refuses.

Prevention of nephrogenic arterial hypertension

Prevention of this disease is based on the prevention of renal pathology, which leads to the above symptom.

First, you need to beware of hypothermia, both general and local supercooling of the lumbar region. This can lead to inflammatory diseases of the kidneys, which are accompanied by increased blood pressure.

Also, when using any medication, you need to pay attention to expiration dates and side effects. People who have had problems with urination in the past, antibiotics can be used only after consulting a specialist and conducting a whole list of laboratory tests.

Rev.doctor urologist Astashin Е.Е.