Clinical Manifestations and Stages of Hypertensive Kidney Failure

              Clinical manifestations of hypertensive kidney failure

1、Severe edema:  Frequently the first symptom is edema which is swelling all the body and usually pit.Serious patients will have hydrothorax and ascites which could cause dyspnea ,umbilical hernia.inguinal hernia.Highly edema is accompany with little urine,hypertension and mild azotemia.

2、Massive proteinuria:It's the major of nephrotic syndrome,urine protein equalization almost be ++ ～ ++++,Adults excrete urine protein ≥3.5g/d,almost selectivity urine protein.

3、Hypoproteinemia:plasma protein has decreased,serum albumin <30g/L,serious patients <10g/L.

              4、Hyperlipemia：blood cholesterol and triglycerides has increased obviously .

Stage of hypertensive kidney failure

In clinical, hypertensive nephropathy has been divided into follow stage according to the patients condition:

Ⅰ——microalbuminuria:The characteristic is the urine albumin excretion rate is abnormal .renal function is normal,routine urine protein is negtive.

Ⅱ——clinical albuminuria ：The characteristic is routine urine protein is positive , urinary protein of 24hours more than 0.5g,The renal function is normal.

              III——Renal function is incomplete:The characteristic is the Ccr decrease and the SCr increase.Divided of the non-dialysis phase and the dialysis phase(the uremia phase).

non-dialysis phase :Ccr within 40～10ml/min，133μmol/L

Ccr<10ml/min. Scr>707μmol/L。

              dialysis phase (uremia):Ccr<10ml/min. Scr>707μmol/L

Diagnosis of hypertensive kidney failure 

The age is almost above 40-50 and the medical history of hypertension is more than 5-10 years. Early stage it is only the increase of nocturia,and then proteinuria ensues.Individual case may happen the transient gross hematuriabecause of capillary broken,but not accompany with obvious backache.It often accompany with arteriosclerotic retinopathy ; Left ventricular hypertrophy ;coronary disease;cardiac failure;cerebral arteriosclerosis and cerebrovascularaccident.The course of the disease develops slowly,the small part progress to kidney failure gradually,the most that renal function is mild damage through out the year and the routine urine is abnormal.The diastolic pressure of malignant hypertension needs to over 16Kpa(120mmHg) and is accompany with booming Cardio-cerebral complications,massive proteinuria with hematuresis,and renal function loss progressively.