The difference between hypertensive nephropathy and renal hypertension

Written by Zhou Qi
Nephrology
Updated on January 30, 2025
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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 Zhang Yue Mei
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Symptoms of hypertension

Hypertension is a common and frequently occurring disease clinically. Mild hypertension often has no clinical symptoms and is usually detected during physical examinations when measuring blood pressure reveals an increase. In cases of severe hypertension, individuals with long-term high blood pressure may experience dizziness, a feeling of pressure in the head, and headaches. In serious cases, symptoms can include tinnitus and palpitations, requiring the use of effective antihypertensive medications for management. If patients with hypertension do not use medications to manage their condition, long-term high blood pressure can cause significant harm to the body, leading to cardiovascular and cerebrovascular diseases, hypertension-induced heart disease, and stroke. (Please use medications under the guidance of a doctor.)

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What to eat for high blood pressure

Patients with hypertension need to regularly take antihypertensive medication to bring their blood pressure within the normal range. In daily life, dietary adjustments should be made, avoiding foods high in fats such as fatty meat from animals, offal, fried foods, and sweets. Instead, consume more vegetables high in dietary fiber, vitamins, and trace minerals. Suitable vegetables for people with hypertension include celery, spinach, mung bean sprouts, black fungus, water chestnuts, onions, carrots, winter melon, and Chinese cabbage.

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How to prevent high blood pressure

The main methods to prevent hypertension are as follows: 1. Maintain a balanced diet, avoid long-term excessive intake of sodium salt, and make sure to consume plenty of fresh vegetables and fruits to supplement adequate amounts of potassium salt and dietary fiber; 2. Regularly participate in sports and physical labor, maintain an active lifestyle, avoid a sedentary lifestyle, and prevent significant weight gain; 3. Combine work with rest to avoid repeated fatigue and staying up late; work should be flexible, and ensure sufficient sleep at night; 4. Maintain a good mood, avoid frequent emotional fluctuations, and also avoid long-term mental overstrain; 5. Do not smoke and avoid excessive drinking.

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What should be done at the start of hypertension?

What to do at the onset of hypertension, specifically refers to mild early-stage hypertension. Mild early-stage hypertension can be managed through reasonable dietary adjustments and increased physical activity to lower blood pressure to normal levels. Generally, it is not necessary to use antihypertensive medications. Aerobic exercises such as swimming, skipping rope, square dancing, playing table tennis, volleyball, tennis, can increase vascular elasticity and improve blood circulation, thereby achieving a blood pressure-lowering effect. In terms of diet, it is important to focus on low-fat, low-salt, and low-oil intake to reduce the occurrence of arteriosclerosis and decrease blood viscosity, as well as sodium and water retention which can cause elevated blood pressure. Pay attention to rest, avoid overworking, and do not get overly excited. These are effective treatment and prevention methods for initial mild hypertension.

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How should one take medicine for high blood pressure?

Patients with hypertension must use effective medications to keep their blood pressure within the normal range to prevent damage to the cardiovascular and cerebrovascular systems. During medication use, patients should not arbitrarily stop taking their medication or switch to different types. It is necessary to regularly monitor blood pressure and adjust the medication dosage or switch types under the guidance of a doctor as blood pressure fluctuates. Randomly stopping medication and discontinuing antihypertensive drugs can cause blood pressure fluctuations and pose greater risks to the body, especially causing ischemia in the heart and brain.