A 70 - year - old man, high blood pressure for 10 years, a few years ago with antihypertensive drug in the treatment of blood pressure control is steady, can be in the past two years somehow blood pressure control, added medicine also can not reach the original effect, and blood pressure fluctuations, when up to 180/120 MMHG.
5 days ago there's no reason, without warning the nasal bleeding, blood pressure is 170/100 MMHG, tamponade hemostasis after think it's all right, but the next day took out after filling the cotton ball still bleeding and to hospital for medical treatment, otolaryngology made after the treatment the patient received my treat.
After admission, the blood pressure was 160/90mmhg, the arteriosclerosis of the bottom of the eye, 7.7.3 cm in the left kidney, and the size of the right kidney was 11cm, the bilateral carotid artery and the lower extremities were narrow and closed. The left glomerular filtration rate was 7.73 ml/min (less than 10 is considered to be unfunctional) and the right kidney was normal. The initial diagnosis is hypertension, ischemic kidney disease, and left kidney atrophy. Analysis of the atrophy of the left kidney was caused by atherosclerosis of the left renal artery and the stenosis of the left renal artery, the left renal ischemic atrophy.
Based on these results, that he should be the process: first, the primary hypertension left renal atherosclerosis resulting from prolonged hypertension, lead to renal artery stenosis, renal artery stenosis caused by changes in two aspects: 1, produce renovascular hypertension, on the basis of the original hypertension, blood pressure rise further, and volatile, deteriorating fast, difficult to control; Kidney ischemia gradually atrophy and kidney function gradually decreases.
This is the case of the old man, which explains why the good blood pressure that was under control became uncontrollable.
Arteriosclerosis is a systemic disease, the coronary arteries of the heart are hardened and the kidney arteries may harden. But, unlike the heart, the heart is a little short of blood and it causes attention. In the kidney, most of the kidney disease is asymptomatic, and the patient may not have any symptoms, even with proteinuria and haematuria, so they are often ignored. And some kidney diseases, such as this renal ischemic atrophy, have never felt anything, and the kidney atrophy has lost its function and there is no typical symptom. 'if it doesn't feel good,' he said, 'he checked.'
This "immaterial" of the kidney is terrible and often delayed treatment. Kidney, however, is not a "gentle", hurt not direct "confrontation", but rather to "silent revenge" - your blood pressure high damage to me, I'm something cause blood pressure higher damage.
The master's left kidney function is almost impossible to recover, so the best treatment for the arterial stenosis is early detection.
The following situations must be further examined:
1,Severe hypertension after age 55;
2, the blood pressure that controls stability has fluctuated;
3,The size of the two kidneys is over 1.5 cm;
4,Increased blood creatinine for unknown reasons;
5,The heart failure of an unknown cause;
6, unexplained pulmonary edema.