高血压肾损害诊治新认识  

New concepts for diagnosis and treatment of hypertensive nephropathy

作　　者：蔡广研[1] 寇佳[1] 陈香美[1] 

机构地区：[1]解放军总医院肾脏病科全军肾脏病研究所,北京100853

出　　处：《中国实用内科杂志》2013年第3期173-175,共3页Chinese Journal of Practical Internal Medicine

摘　　要：高血压肾损害是由于长期血压增高引起肾内小动脉及细小动脉病变,导致肾脏缺血性改变的一组临床综合征,是终末期肾脏疾病(ESRD)的重要病因。高血压肾损害的临床及病理表现缺少特征性改变。因此,临床诊断需要仔细鉴别以除外其他肾脏疾病。近年来反映肾小管功能指标、微量白蛋白尿、肾小球高滤过等成为新的诊断指标。确定降压目标值应考虑患者年龄、蛋白尿及肾功能水平。以肾素-血管紧张素系统(RAS)阻断剂为基础进行联合降压治疗,纠正代谢异常、调整生活方式等综合措施,有利于改善肾脏远期预后,并减少心脑血管并发症。Hypertensive nephropathy, the syndrome clinically resulting from intrarenal arteriolar and small arterial lesion leading to renal ischemia, has been the critical cause for end-stage renal disease （ ESRD ）. Differential diagnosis of miscellaneous renal diseases is necessary inasmuch that hypertensive nephropathy lacks typical clinical and pathological changes. The diagnostic indices reflecting the renal tubular function, mieroalbuminuria and glomerular hyperfiltration have been available. Goal based on Patient age ,level of proteinuria and renal function should be determined for establishing an antihypertensive target. Renin-angiotensin system antagonist for combined antihypertensive treatment, on the basis of integrated approaches for correcting metabolic disorders and adjustment of life style ,may improve the long-term prognosis and reduce the complications of cardiovascular systems.

关 键 词：高血压 肾疾病 终末期肾脏疾病 

分 类 号：R692[医药卫生—泌尿科学]