Nephrosclerosis - specialists and information

Chronic high blood pressure (hypertension) can lead to a whole range of serious secondary diseases. This includes nephrosclerosis. Nephrosclerosis is a kidney disease that can be benign or malignant . As a result, the course of the disease can be very different. However, the therapy is identical for both: the aim is to lower blood pressure and prevent further damage to the kidney tissue.

Below you will find further information and selected nephrosclerosis specialists.

Forms of nephrosclerosis

A basic distinction is made between:

• Benign (benign) nephrosclerosis
• malignant (malignant) nephrosclerosis

Benign nephrosclerosis is characterized by a slow but continuous progression of damage to the kidney tissue. At the same time, uncontrolled connective tissue is produced, which in turn leads to tissue hardening (sclerosis) in the kidney. Another accompanying symptom is hyalinosis (storage of transparent substances). The course of benign nephrosclerosis can extend over a period of several years.

In contrast, the course of the disease in malignant nephrosclerosis is shorter and more severe: there is a sudden deterioration in kidney function and the blood pressure rises sharply. Experts also call this progression a hypertensive crisis.

There are three stages of the disease:

1. Microalbuminuria: excretion of increased amounts of the protein albumin via the urine. (30 - 300 mg/d)
2. Benign hypertensive nephrosclerosis: These are > 300 mg/d
3. Arterio-arteriolosclerotic: shrunken kidneys with renal insufficiency

Experts also differentiate between nephrosclerosis with and without renal insufficiency.

Albuminuria (protein) is the main symptom of kidney disease @ Saiful52 /AdobeStock

Typical symptoms of nephrosclerosis

Both benign and malignant nephrosclerosis initially present with the symptoms of arterial hypertension (high blood pressure).

The symptoms are often quite unspecific and include dizziness, visual disturbances or a feeling of tightness in the chest.

The benign form of nephrosclerosis is accompanied by gradual symptoms of kidney failure, while the malignant form is characterized by acute symptoms.

These include

• Decrease in urine production
• Accumulation of fluid in the lungs (pulmonary oedema)
• muscle weakness
• Cardiac arrhythmia
• Complete loss of kidney function

Risk factors for nephrosclerosis disease

The likelihood of developing nephrosclerosis depends on several factors:

• For example, people of black African descent are about four times more likely to develop the disease than people with white skin color.
• Other risk groups are men, people over 50, smokers and people with a low socio-economic status, i.e. a lower level of education.
• Pre-existing conditions such as a lipid metabolism disorder or a reduced number of renal corpuscles (nephrons) also play a major role.
• There may also be a genetic susceptibility to nephrosclerosis.

Diagnosis of nephrosclerosis

• Benign nephrosclerosis is often initially a suspected diagnosis that arises during a routine blood test.
• If the doctor has detected damage to the kidneys, the urine is examined. An increased protein concentration is typical.
• Equally important are comprehensive physical examinations and a detailed medical history (a survey of the patient's medical history). During the anamnesis, the patient describes the existing symptoms in detail and the doctor identifies particular risk factors.
• Absolute certainty about the presence of nephrosclerosis can only be obtained by taking a tissue sample. However, a kidney biopsy entails numerous complications, which is why experts often refrain from doing this in practice. Treatment aimed primarily at restoring and maintaining kidney function is also possible without a biopsy.

Nephrosclerosis: prognosis and therapy

The prognosis for the benign variant depends heavily on whether irreparable damage to the kidneys has already occurred. Early diagnosis and treatment is therefore of great importance.

In the malignant form of the disease, which occurs less frequently, the focus is on normalizing the blood pressure. In this way, experts can prevent permanent damage and kidney failure.

The reduction of high blood pressure as a trigger for kidney disease is at the heart of every therapy. Antihypertensive drugs - ACE inhibitors or alternatively AT1 antagonists - are used for this purpose.

Nephrosclerosis always occurs together with high blood pressure @ stivog /AdobeStock

The level of blood pressure reduction depends on protein excretion: If protein is elevated, aim for <130/80 mmHg, otherwise 140/90 mmHg.

In addition to taking medication and strict, regular monitoring of blood pressure, a healthy lifestyle is of great importance.

Sporting activities and weight reduction can also have a positive effect on your state of health.

There are other measures that can be taken to lower blood pressure:

• Reducing stress (for example through relaxation exercises)
• Limiting salt intake when eating
• Avoiding alcoholic drinks
• A healthy diet is very important so that the kidney tissue can regenerate. Among other things, omega-3 fatty acids, amino acids, antioxidants and foods that naturally help to lower cholesterol are beneficial.)