Renal sclerosis

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

　　2. Benign renal sclerosis:Vascular lesions caused by hypertension and intraglomerular hypertension can lead to 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 senior 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 divided into benign and malignant renal small artery arteriosclerosis in clinical practice. The former has a longer course, generally 20 years, but a small number of patients (1%-8%) may progress to the malignant phase during the course of the disease, and may die within 1-2 years if not treated in time. The latter has rapid progression of the disease, acute deterioration of renal function, and short-term entry into renal function uremia. It is often accompanied by the failure of multiple organs such as the heart and brain. If not treated in time, the mortality rate may reach above 50% within 3 months and 90% within 1 year. Early and patient treatment is crucial, and the key is to keep the blood pressure within the normal range for a long time. The prognosis of most patients with benign renal small artery arteriosclerosis is optimistic.

　　Patients with arteriosclerotic renal sclerosis may exhibit systemic atherosclerotic manifestations of arterial sclerosis, such as heart, brain, and peripheral vascular sclerosis, with or without hypertension. In the benign phase of primary hypertension, the manifestations include overweight, headache, dizziness, palpitations, shortness of breath, mental tension, and chest pain. In the malignant phase, the manifestations include headache and hypertensive encephalopathy, weight loss, visual impairment, early renal sclerosis may have lumbago, lumbar pain, edema, hematuria, nocturia, and late renal function failure.

　　Patients with arteriosclerotic renal sclerosis may exhibit systemic atherosclerotic manifestations of arterial sclerosis, such as heart, brain, and peripheral vascular sclerosis, with or without hypertension. In the benign phase of primary hypertension, blood pressure often moderately increases, leading to congestive heart failure or cerebrovascular accidents, and only a few patients die of renal failure. In the malignant phase, diastolic pressure is often above 130mmHg, and papilledema is a prominent feature, sometimes accompanied by hemorrhage and exudates, often leading to renal failure.

　　1. Diet nourishment

　　It is forbidden to eat spicy and sweet and greasy foods, eat low-salt diet, quit smoking and drinking, eat in moderation, and usually have light and vitamin-rich diet.食疗方 can be selected according to the condition.

　　2. Daily life and living

　　Lifestyle should be regular, participate in appropriate physical exercise regularly, and pay attention to the combination of work and rest.

　　3. Differential nursing care

　　Psychological counseling is provided to the patients to build their confidence in treatment. At the same time, methods for controlling emotions and adjusting mental states are taught to the patients. A comfortable environment is arranged for the patients, keeping the ward quiet, avoiding noise and bed frame摇晃, and the light should not be too strong. For those with yin deficiency, it is recommended to eat less ginger, mutton, and other foods, and more yin-nourishing products; for those with yang deficiency, attention should be paid to keeping warm and eating 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, and may present as gross hematuria in severe cases.

　　2. Renal function examination:Patients in the benign stage, with mild to moderate hypertension, generally have no effect on renal function, and severe hypertension often reduces GFP to 65ml/min, before the onset of renal insufficiency, hyperuricemia may be an earlier manifestation, reflecting a decrease in renal blood flow caused by arterial and small arterial lesions.

　　3. Renal biopsy.

　　1. Prefer light and easily digestible foods, avoid seafood, beef, mutton, spicy刺激性 foods, alcohol, and all kinds of irritants such as five-spice powder, coffee, coriander, etc.; especially for patients with Yin deficiency, such as red tongue, large pulse, night sweats, dry stool, hematuria, etc.; but for patients with Yang deficiency, such as pale tongue with white fur, deep pulse, cold body and limbs, loose stool, can eat hot foods.

　　2. Prefer fresh vegetables and moderate amounts of fruit, drink water appropriately; avoid all tonics, tonics, and easily hot foods such as chili, lychee, chocolate, etc. Especially for patients with Yin deficiency and internal heat, such as purple tongue, slow pulse, chest tightness, abdominal distension, and blood stasis.

　　Although benign renal sclerosis is one of the most common diagnoses in end-stage renal failure (ESRD) patients, the progression is generally slow in the absence of any risk factors; only some patients with obvious essential primary hypertension may develop progressive kidney disease. However, so many patients with chronic hypertension, a few of whom are at risk of renal failure, constitute a large population prone to ESRD. Progressive renal insufficiency is directly related to the severity and control of hypertension. Therefore, clinical treatment mainly focuses on the treatment of hypertension. Hypertension treatment to diastolic blood pressure <90mmHg can usually prevent the aggravation of renal injury. ACE inhibitors and ARBs are more kidney-protective than other antihypertensive drugs.