Renal sclerosis

　　1. Arteriosclerotic renal sclerosis:The pathogenesis is the same as that of atherosclerosis in other organs.

　　2. Benign renal sclerosis:Hypertensive vascular lesions and intraglomerular hypertension can cause glomerular injury. Vascular and glomerular lesions in benign renal sclerosis can also be seen in the elderly, even in patients without hypertension. These changes may be related to the progressive decline of elderly GFP.

　　3. Malignant renal sclerosis:The initial lesion is caused by vascular wall injury due to a sudden increase in blood pressure.

　　Renal arteriosclerosis, secondary to hypertension, can be clinically divided into benign and malignant renal arteriolar sclerosis. The former has a longer course, generally lasting 20 years, but a small number of patients (1%-8%) may progress to the malignant phase during the course of the disease. If not treated in time, they often die within 1-2 years. The latter has rapid progression of the disease, with a sudden deterioration of renal function, entering renal failure and uremia in a short period of time. It is often accompanied by multi-organ dysfunction of the heart, brain, and other organs. If not treated in time, the mortality rate reaches over 50% within 3 months and 90% within a year. Early and patient treatment is the key to controlling blood pressure at a normal level for a long time, and the prognosis of most patients with benign renal arteriolar sclerosis is optimistic.

　　Patients with arteriosclerotic renal sclerosis can show manifestations of systemic arteriosclerosis, such as heart, brain, and peripheral vascular sclerosis, with or without hypertension. The manifestations of the benign phase of primary hypertension include overweight, headache, dizziness, palpitations, shortness of breath, nervousness, and chest pain. The manifestations of the malignant phase include headache and hypertensive encephalopathy, weight loss, visual impairment, and in the early stage of renal sclerosis, symptoms such as lumbago, back pain, edema, hematuria, and frequent nocturia can be seen. In the late stage, manifestations of renal function failure can be observed.

　　Patients with arteriosclerotic renal sclerosis show manifestations of systemic arteriosclerosis, such as heart, brain, and peripheral vascular sclerosis, with or without hypertension. The blood pressure in the benign phase of primary hypertension is often moderately elevated, eventually leading to congestive heart failure or cerebrovascular accidents, with only a few patients dying of renal failure. In the malignant phase, diastolic blood pressure is often above 130mmHg, with papilledema as its prominent feature, and sometimes bleeding and exudates can also be seen, often leading to renal failure.

　　1, Dietetic care:Avoid spicy and greasy foods, eat low-salt diet, quit smoking and drinking, eat in moderation, eat light and vitamin-rich diet as a daily staple, and choose the following food therapy formulas according to the condition.

　　2, Daily life and living: Have a regular life.Regularly participate in appropriate physical exercise and pay attention to the combination of work and rest.

　　3, Syndromic nursing care:Provide psychological counseling to patients to help them build confidence in treatment, teach patients some methods to control emotions and adjust their mindset, arrange a comfortable environment for patients, keep the ward quiet, avoid noise and bed shaking, avoid strong light. For those with yin deficiency, eat less ginger, mutton, and other foods, and eat more yin-nourishing foods; for those with yang deficiency, pay attention to keeping warm and eat less cold and cool foods.

　　1, Blood routine, urine routine.

　　Urine analysis: (1) Proteinuria. (2) Red blood cells: mainly seen in patients in the malignant stage, severe cases may present with gross hematuria.

　　2, Renal function examination:In the benign stage, mild to moderate hypertension generally has no effect on renal function, and severe hypertension often reduces GFP to 65ml/min, which may be an early manifestation before renal insufficiency occurs. Hyperuricemia may be an early manifestation, reflecting reduced renal blood flow caused by atherosclerosis of arteries and small arteries.

　　3, Renal biopsy.

　　What should be paid attention to in the diet of renal sclerosis:

　　1, Absolutely no alcohol.

　　2, Choose skimmed milk or yogurt.

　　3, Do not eat more than two egg yolks a day.

　　4, Avoid animal oil; the total amount of vegetable oil should not exceed 20 grams.

　　5, Do not eat animal internal organs (i.e., offal, offal), chicken skin, fatty meat, and fish roe, crab roe.

　　6, Avoid fried and fried foods.

　　7, Do not eat chocolate.

　　8, Often eat low-fat dairy products and wheat gluten.

　　9, Consume 500 grams of fresh green vegetables every day.

　　Patients with arteriosclerotic renal sclerosis may show systemic atherosclerotic manifestations such as heart, brain, and peripheral vascular sclerosis. The treatment of renal sclerosis is mainly symptomatic treatment. During treatment, it is necessary to actively treat the primary disease. Patients with renal sclerosis generally have a good prognosis, and only a few cases develop into renal failure.