What is the general blood pressure for hypertensive nephropathy?

Written by Zhou Qi
Nephrology
Updated on September 17, 2024
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Hypertension caused by kidney disease is called renal hypertension. The blood pressure of patients with renal hypertension is generally higher than that of those with primary hypertension. However, these patients can exhibit any range of blood pressure types. Their blood pressure might be in stage 1, meaning the systolic pressure is between 140 to 160 mmHg. It could also reach stage 3, where the systolic pressure exceeds 180 mmHg. In cases of heart failure, the patient's blood pressure might even reach 220 or 240 mmHg, though such extreme cases are relatively rare.

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Written by Li Qiang
Intensive Care Unit
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How to treat hypertensive encephalopathy

The treatment goal for hypertensive encephalopathy is mainly to rapidly reduce blood pressure to a reasonable range. Typically, intravenous antihypertensive drugs are administered to decrease blood pressure by 20%-25% within the first hour, followed by oral antihypertensives or continued intravenous treatment to further reduce it to a more reasonable level. Hypertensive encephalopathy often accompanies cerebral edema, and patients may experience increased intracranial pressure. At this point, it is necessary to administer dehydrating agents such as mannitol to treat the cerebral edema. If the patient experiences seizures, which can cause an increase in blood pressure or difficulty in reducing blood pressure, sedative anticonvulsant drugs must be administered to control the seizures. If the patient shows signs of heart failure, diuretic treatment should be initiated. Additionally, high concentration oxygen therapy under high pressure should be administered, which can be delivered through nasal cannula. If nasal oxygen therapy is ineffective, non-invasive ventilation or even intubation with invasive ventilation may be used to provide high concentration positive pressure oxygen therapy.

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Written by Zhou Qi
Nephrology
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The difference between hypertensive nephropathy and renal hypertension

Hypertensive nephropathy and hypertension due to kidney disease need to be differentiated, as this affects the treatment approach and prognosis assessment differently. Hypertensive nephropathy refers to patients with long-term high blood pressure, which causes arteriosclerosis of small vessels leading to renal pathology. Often, there is also arteriosclerosis in other organs, such as the retinal arteries, which can be confirmed through funduscopic examination. On the other hand, hypertension due to kidney disease occurs when a patient has kidney disease first followed by hypertension, where the causes and types of kidney diseases vary and can frequently lead to hypertension. The difference between the two lies in the sequence of occurrence. Hypertensive nephropathy is characterized by initial high blood pressure and commonly associated with arteriosclerosis in other vessels, which can be preliminarily identified through funduscopic examination. In cases of hypertension due to kidney disease, the patient has other kidney disorders first, followed by hypertension. If a patient's 24-hour urine protein quantification exceeds 2g, it is likely due to kidney disease rather than hypertensive nephropathy. If differentiation remains challenging, kidney biopsy can be performed for further differentiation.

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Written by Pan Wu Shan
Nephrology
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What is the difference between hypertensive nephropathy and renal hypertension?

There are fundamental differences between hypertensive nephropathy and nephrogenic hypertension. Firstly, hypertensive nephropathy occurs due to long-term high blood pressure, leading to complications in the kidneys. Generally, the history of hypertension exceeds ten years, and routine urine tests reveal a relatively small amount of protein in the urine. The main damage lies in the renal tubules, whose reabsorption and concentration functions are impaired. The primary treatment is to control the blood pressure well, possibly in conjunction with medication to protect the kidneys. On the other hand, nephrogenic hypertension originates from nephritis causing high blood pressure and is a form of secondary hypertension. In this condition, controlling blood pressure is particularly challenging. Usually, a significant amount of antihypertensive medication is required. Dietary considerations include a low salt and low fat diet, with daily salt intake limited to about three grams, maintaining regular schedules, and avoiding catching colds.

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Pregnancy hypertension symptoms

The symptoms of hypertension during pregnancy vary depending on the blood pressure level, individual tolerance, and other factors. Common symptoms include high blood pressure, protein in the urine, and generalized edema. Edema can vary in severity; it can start with bilateral ankle swelling, progress to the calves, thighs, and then become generalized throughout the body. Increased blood pressure can also lead to headaches, dizziness, nausea, and blurred vision. In more severe cases, pain in the upper abdomen and convulsions may occur.

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Causes of high blood pressure

Hypertension is clinically divided into primary hypertension and secondary hypertension. Primary hypertension is characterized by elevated blood pressure without other symptoms, and the current clinical diagnostic methods cannot determine the cause of the blood pressure rise, which is referred to as primary hypertension. Secondary hypertension occurs as a result of other diseases, with the most common being hyperthyroidism, glomerulonephritis, arteritis, atherosclerosis, and other diseases causing high blood pressure. After the onset of hypertension, effective antihypertensive drugs must be used for treatment. Hypertension is not to be feared, but the damage it causes to the body is. (Specific medications should be used under the guidance of a physician)