Hypertension and Renal Disease

Posted by e-Medical PPT Saturday, August 6, 2011
What are Symptoms and Complications of Untreated or Undiagnosed Hypertension?
 Usually Asymptomatic (95%) Unless Severe
 Severe: Dizzines, Ringing in Ears, Headaches, Fainting Spells, Blurred Vision, Epistaxis (Bleeding Nose) or other  Prolonged Bleeding
Complications - Undiagnosed or Untreated
 Accelerated Atherosclerosis
 Increased Risk of Myocardial Infarction (M / Heart AttackI) and Cerobrovascular Accidents (CVA / Stroke)
 Congestive Heart Failure (CHF)
   Swollen Ankles
   Shortness of Breath
Small Risk of Eye and/or Renal Damage

What is Renal (Kidney) Disease?
Inflammatory / Infectious Disease (Usually) that Damages Kidney and Alters Kidney Function
 Glomerulonephritis: Immunopathic Disease of Glomerulus (Many Sub- Types)
 Pyelonephritis:  Infection of Connective Tissue and Tubules
May Require:
 Dialysis (End-Stage - Renal Failure) (300,000)
 Transplant (End-Stage - Renal Failure) (30,000/yr)
May interfere with:
 Drug Metabolism
 Infection Control and Wound Healing
 Bleeding (Platelet Adhesion Inhibition)
Renal Failure May also be Associated with:
 Anemia (loss of erythropoietin)
 Secondary Hyperparathyroidism (loss of Ca++) **
 Uremic Stomatitis **  or Oral Candidiasis

What is Relationship of Renal Disease to Hypertension
Renal Disease may damage the kidney blood supply and activate the RENIN-ANGIOTENSIN system (Release of Renin with ultimate formation of Angiotensin II which raises BP via vasoconstriction and sodium retention) - A form of secondary hypertension
HTN may damage the blood supply to the kidney (via accelerated atherosclerosis or arteriolosclerosis) and further contribute to its own progression
Altered function may increase Na+ and fluid retention with increased blood volume and pressure

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