Benign Hypertensive Arteriolosclerosis

　　Renal sclerosis occurs with age, but it can be aggravated by chronic hypertension. The overall incidence of progressive kidney disease in patients with chronic hypertension is relatively low, and most patients have mild hypertension. Three factors increase the risk of renal sclerosis: black race, moderate to severe hypertension, and other pre-existing kidney diseases (such as diabetic nephropathy).

　　This disease is accompanied by severe hypertension and rapid progressive renal failure. Renal arteriosclerosis, secondary to hypertension, can be clinically divided into benign and malignant arteriolosclerosis of the kidney. The former has a longer course, generally 20 years, but a small number of patients (1%-8%) may progress to the malignant stage during the course of the disease. If not treated in time, they often die within 1-2 years. The latter develops rapidly, the renal function deteriorates rapidly, and enters renal failure uremia in a short period of time. It is often accompanied by the degeneration of multiple organ functions such as the heart and brain. If not treated in time, the mortality rate reaches more than 50% within 3 months and 90% within a year. As long as treatment is started early and patience is maintained, the key is to keep the blood pressure within the normal range for a long time, and the prognosis of most patients with benign arteriolosclerosis of the kidney is optimistic.

　　The renal tubules are sensitive to ischemia, so the clinical manifestations of renal tubular concentrating dysfunction appear first (polyuria at night, low specific gravity and low osmotic pressure urine). When the ischemic lesions of the glomeruli occur, abnormal findings are seen in urine tests (mild proteinuria, a small number of red blood cells and casts), and the glomerular function progressively deteriorates (intrinsic creatinine clearance decreases, followed by an increase in serum creatinine), and gradually progresses to end-stage renal failure. This disease often occurs simultaneously with renal damage, often accompanied by hypertensive fundus lesions and cardiovascular and cerebrovascular complications.

　　Attention to lifestyle habits is an important means of preventing this disease. The following will introduce the common measures for preventing this disease.

　　1. Exercise

　　Strengthen physical exercise, increase the body's resistance. Pay attention to the combination of work and rest, and walk every day to the extent that the body does not feel tired, improve the body's resistance, prevent colds, and prevent the disease from worsening due to respiratory tract infections and other triggers.

　　2. Maintain unobstructed urination

　　Unobstructed urination indicates that the excretory function of the kidneys is normal. If there is urethral obstruction, unobstructed urination will increase the chance of inflammation of the renal pelvis and renal parenchyma, increase the burden on the kidneys, and even lead to uraemia.

　　3. Pay attention to diet

　　Pay attention to eating light, easy-to-digest foods, and let the patient understand the importance and necessity of correct diet. Avoid eating raw, hard, cold foods, overeating, and overindulgence in sweet and greasy foods.

　　Through urine testing, it may be found that the concentration of urea nitrogen and plasma creatinine in the patient may slowly increase, and hyperuricemia (not dependent on diuretic treatment) may occur. An early discovery may reflect a decrease in renal blood flow caused by vascular disease. Typical urine analysis shows a small number of cells or casts, and protein excretion is usually <1g/d, but sometimes within the range of kidney disease, patients with significant proteinuria often have overlapping renal vascular diseases.

　　Patients with this disease should pay attention to eating light, easy-to-digest foods, avoid eating raw, hard, cold foods, overeating, and overindulgence in sweet and greasy foods. To protect the kidneys, it is necessary to consume protein and carbohydrates and avoid high-fat diets. Excessive fat in the diet can easily lead to arteriosclerosis of the renal arteries, causing atrophy and变性 of the kidneys, and causing arteriosclerotic kidney disease. Alkaline foods are beneficial to the kidneys and can prevent urinary tract stones. It is also appropriate to eat some winter melon, white grass root, red bean, mung bean, etc., which are beneficial for diuresis, clearing heat, and protecting the kidneys.

　　The focus of treatment for this disease is on prevention, and actively treating hypertension is crucial. Blood pressure must be controlled to meet the standard (mean arterial pressure below 100mmHg, systolic pressure below 140mmHg) to prevent the occurrence of kidney damage due to hypertension. Controlling hypertension is still the key to delaying the progression of kidney damage after benign arteriolosclerosis. If renal function has deteriorated, it should be treated as chronic renal failure.