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Nephrosclerosis is the hardening of small kidney arteries leading to ischemia and kidney damage, commonly associated with hypertension and aging. It has two types: benign nephrosclerosis, which progresses slowly and is often asymptomatic, and malignant nephrosclerosis, which progresses rapidly and can cause acute renal failure. Management includes controlling hypertension and lifestyle modifications, with investigations revealing proteinuria, hematuria, and renal insufficiency.

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8 views10 pages

Untitled Design 5

Nephrosclerosis is the hardening of small kidney arteries leading to ischemia and kidney damage, commonly associated with hypertension and aging. It has two types: benign nephrosclerosis, which progresses slowly and is often asymptomatic, and malignant nephrosclerosis, which progresses rapidly and can cause acute renal failure. Management includes controlling hypertension and lifestyle modifications, with investigations revealing proteinuria, hematuria, and renal insufficiency.

Uploaded by

santhiyas039
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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NEPHROSCLEROSIS

BY SANTHIYA G [11231173]
Definition
Hardening of small kidney arteries and arterioles
causes ischemia

Ischemic atrophy of renal parenchyma leads to


kidney damage

Commonly associated with hypertension and aging


Etiology and risk factors
Primary or secondary hypertension

Advancing age

Diabetes mellitus

Smoking

Genetic predisposition

Atherosclerosis
Types and pathogenesis

Benign nephrosclerosis Malignant nephrosclerosis


Slow progression,common in elderly Rapidly progressive in malignant or
and hypertensive patients,usually accelerated hypertension,can cause
related to benign hypertension acute renal failure

Chronic hypertension causes hyaline Severely elevated bp causes fibrinoid


arteriosclerosis.luminal narrowing necrosis of arterioles and hyperplastic
leads to ischemia and glomerular arteriosclerosis (onion skin
sclerosis. appearance);acute ischemia
Gross of benign
nephrosclerosis
Both the kidneys are equally
affected reduced in size and
weight smaller,with finely
granular,firm cortical surface
and V shaped scarring.The cut
surface shows firm and
narrowed cortex
Malignant
nephrosclerosis
Shrunken,edematous with
petechial hemorrhage;cut
surface shows yellow
mottled appearance(flea
bitten appearance)
Microscopy of benign
nephrosclerosis
Vascular changes;hyaline
arteriosclerosis thickens small vessel
walls;Intimal thickening due to smooth
muscle proliferation

Parenchymal changes;Ischemia causes


glomerular shrinkage and tubular
atrophy ;collagen deposition and
interstitial fibrosis occur
Malignant nephrosclerosis
Vascular changes;fibrinoid necrosis of
vessel walls with inflammation;onion
skin hyperplastic arteriolitis by
smooth muscle proliferation

Ischemic consequences;Tubular loss


and interstitial fibrosis;areas of
infarction and necrosis in renal
parenchyma
Clinical features and complications
Benign nephrosclerosis;often asymptomatic,slow renal insufficiency
progression,mild proteinuria

Malignant nephrosclerosis;sudden severe


hypertension,headache,visual changes,nausea,acute renal failure with
hematuria and proteinuria

Complications;chronic kidney disease,end stage renal


disease,cardiovascular events and LV hypertroph
Investigations and management
Urinalysis-proteinuria,hematuria:serum creatinin&BUN-elevated in
renal insufficiency,Fundoscopy-hypertensive retinopathy,Renal
imaging-shrunken kidneys in chronic cases,Renal biopsy-rare

Control of hypertension(ACE inhibitors),(ARB),lifestyle


modifications:Salt restriction,weightloss,smoking
cessation,dialysis,renal transplant

*THANK-YOU*

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