When nephrosclerosis is present, an affected person’s kidney is affected. Early therapeutic steps usually increase the success of treatment.
What is nephrosclerosis?
Nephrosclerosis is a kidney disease also known as vascular or hypertensive nephropathy, among others. Very often, nephrosclerosis is associated with elevated blood pressure in affected individuals. A distinction can be made between so-called benign (benign) and malignant (malignant) nephrosclerosis. The benign form of nephrosclerosis is characterized, among other things, by the formation of hardening in the arterioles (the smallest arteries of the kidney). Often, the benign form of nephrosclerosis does not initially cause any symptoms in those affected; if symptoms do occur, they are manifested, for example, in headaches, restlessness and/or loss of appetite. While renal function is usually unaffected by benign nephrosclerosis, affected patients are often more prone to renal pelvic inflammation. In the course of malignant nephrosclerosis, changes in kidney tissue and vascular walls occur in most cases. Possible symptoms of advanced disease include blurred vision or states of confusion.
Causes
Benign nephrosclerosis often follows from atherosclerosis (a hardening of the arteries) present in the affected person, which is associated with elevated blood pressure. The malignant form of nephrosclerosis, for example, can be caused by very high blood pressure. Various kidney diseases and the use of contraceptive drugs can also promote malignant nephrosclerosis. The role of various viral diseases as triggers of malignant nephrosclerosis has not been conclusively clarified. The occurrence of nephrosclerosis may also be favored by various risk factors. These risk factors include, for example, a high level of nicotine consumption, a family history of nephrosclerosis, disorders of lipid metabolism and/or impaired kidney function. Comparatively, nephrosclerosis occurs more frequently in persons of older age, male sex, or black skin color.
Symptoms, complaints, and signs
Nephrosclerosis always occurs together with increased blood pressure, since high blood pressure is the only cause of sclerotic changes in kidney tissue. In most cases, there are no symptoms at the beginning of the disease, since both high blood pressure and nephrosclerosis may be asymptomatic at first. However, non-specific symptoms of hypertension such as visual disturbances, dizziness or even tightness in the chest are often already noticed. Depending on the hypertension, the development of two different forms of nephrosclerosis is possible. Thus, there is a benign (benign) and a malignant (malignant) course of this disease. In benign nephrosclerosis, no symptoms are usually observed. Only blood tests may reveal an increased excretion of proteins. However, if left untreated for a very long time, renal insufficiency may develop, which is manifested by decreasing urine production, formation of pulmonary edema, cardiac arrhythmias, and muscle weakness. However, before this condition occurs, the disease processes in benign nephrosclerosis can be stopped and even reversed. In malignant nephrosclerosis, although similar symptoms occur, this is a sudden onset and rapidly progressive disease process. In the case of acute kidney failure, this can be fatal. In addition, nausea, vomiting, severe headaches, states of confusion, apathy, coma and convulsions also occur here, which can often lead to heart failure. Blood pressure rises sharply. A cure for renal failure is often no longer possible at this stage of the disease.
Diagnosis and progression
Diagnosis of existing nephrosclerosis usually begins with a detailed patient interview. During this discussion, an attending physician asks, for example, about the duration and severity of existing symptoms. Information on the patient’s medical history is also usually requested. Information obtained from the interview can subsequently be supplemented, for example, by examinations of the blood and urine of an affected person; for example, the suspicion of nephrosclerosis can be corroborated by an elevated protein concentration in the urine.Malignant nephrosclerosis can usually only be confirmed with the help of a biopsy (a removal of kidney tissue). Benign nephrosclerosis usually progresses slowly. Occasionally, kidney failure can occur in the advanced course. Malignant nephrosclerosis can cause damage to the heart and brain due to severely elevated blood pressure. Severe disease progression may result in coma and/or heart failure.
Complications
As a result of nephrosclerosis, affected individuals suffer from kidney problems in most cases. However, these have a very negative effect on the patient’s overall health, resulting in inner restlessness and, further, high blood pressure. It is not uncommon for those affected to be confused and suffer from headaches and also bleeding. Likewise, nephrosclerosis can lead to visual disturbances, so that the patients have blurred vision. Coordination disorders and concentration problems also occur, which have a very negative effect on the patient’s quality of life. Patients are also apathetic and listless and no longer take an active part in life. Furthermore, nephrosclerosis also leads to vomiting and permanent nausea of the patient. Nephrosclerosis is treated by kidney transplantation or dialysis. In most cases, however, removal of the damaged kidney is necessary before complete renal failure occurs. If treatment is successful, however, the patient’s life expectancy is not affected. A healthy diet and lifestyle can have a positive effect on nephrosclerosis and reduce symptoms and discomfort.
When should you see a doctor?
Symptoms such as loss of appetite, restlessness, stomach pain or headaches indicate nephrosclerosis or at least a serious condition that must be clarified by a doctor in any case. Anyone who notices these or other symptoms that cannot be attributed to any particular cause should consult their family doctor. Medical clarification is necessary in any case, otherwise serious complications such as chronic gastrointestinal complaints, visual disturbances or internal bleeding may occur. People who regularly consume nicotine or suffer from a fat disorder are particularly at risk. The same applies to patients who have overcome a viral disease or have existing arteriosclerosis. Anyone who belongs to these risk groups must have these complaints clarified immediately. In addition to the general practitioner, an internist or a specialist for arterial diseases can be consulted. In the case of serious illnesses, a visit to a specialist center is necessary. The actual treatment usually takes place in a specialized clinic, although other specialists may be involved in the treatment depending on the type and severity of the nephrosclerosis.
Treatment and therapy
Medical treatment of nephrosclerosis usually focuses primarily on lowering blood pressure. Various drug agents are available for this purpose. A treating physician estimates which antihypertensive agents are suitable in each individual case, taking into account various factors; for example, different preparations may be appropriate for patients affected by nephrosclerosis with increased protein concentration in the urine than for patients whose urine has a normal protein concentration. Medical recommendations for blood pressure levels to be achieved in the treatment of nephrosclerosis also vary depending on various factors; for example, the recommended blood pressure levels in patients with impaired kidney function are lower than the recommended levels in patients with intact kidney function. Early and appropriate therapy can often save lives, especially in patients with malignant nephrosclerosis. The background to this is that malignant nephrosclerosis leads to kidney failure in most cases if left untreated. Once such renal failure has occurred, treatment steps such as regular hemodialysis (blood washing) or surgical removal of the diseased kidney may become necessary.
Outlook and prognosis
Nephrosclerosis is a consequence of chronic high blood pressure. Depending on whether the benign or malignant form of the disease is present, the prognosis can vary widely. Benign nephrosclerosis can persist over a period of many years.During this period, the kidney tissue is constantly damaged and new connective tissue is produced, which causes tissue hardening in the kidney. The consequences of this development are kidney pain, hormonal changes and a decrease in general well-being. The malignant form of nephrosclerosis is accompanied by a sudden deterioration of kidney function. Blood pressure rises sharply and a hypertensive crisis occurs, which is potentially life-threatening. The first step in both forms is to lower blood pressure, for which various drugs are used. The prescribed antihypertensive drugs can cause side effects and make the patient feel unwell. In many cases, the malignant form leads to the death of the patient. In the benign form, a long, relatively symptom-free life is possible. However, the quality of life is limited solely by any side effects and drug interactions, as well as by the progressive increase in symptoms.
Prevention
Nephrosclerosis can be prevented primarily by avoiding or combating high blood pressure. For this purpose, it may be useful to have blood pressure checked regularly. Avoiding risk factors such as heavy smoking can also help prevent nephrosclerosis. If nephrosclerosis has already occurred, regular visits to the doctor allow early therapy.
Follow-up care
In most cases, direct follow-up measures for nephrosclerosis are significantly limited and, in some cases, not available to the affected person at all. These individuals should therefore see a physician early to avoid further complications or discomfort. Self-healing cannot occur, so a doctor should be consulted at the first signs and symptoms. During the treatment of nephrosclerosis, regular checks and examinations by a doctor are necessary in order to detect and prevent further complaints at an early stage. Many of those affected are dependent on taking medication, whereby attention must be paid to the correct dosage. In case of any uncertainties, side effects or other questions, a doctor should always be consulted first. As a rule, the help of relatives and one’s own family is equally important in order to prevent depression and other psychological upsets. The further course of the disease depends very much on the time of diagnosis of nephrosclerosis, so that no general course can be predicted. However, in many cases, the disease can reduce the life expectancy of the affected person.
Here’s what you can do yourself
Nephrosclerosis patients can help treatment by avoiding activities that increase blood pressure. Diet should be changed accordingly. Spicy foods should be avoided. Likewise, coffee should only be drunk in limited quantities. Nephrosclerosis symptoms can also be alleviated by taking moderate exercise. To avoid complications, sports activities should first be discussed with a physician. If available, a blood pressure monitor can be used to measure blood pressure at home by oneself. If a particularly high blood pressure is detected, the physician should be informed. Elderly people and patients with other kidney diseases have particularly poor prospects of recovery. They should make the necessary lifestyle changes to optimally support the therapy. These include exercise and a balanced diet, abstaining from alcohol and nicotine, and avoiding stress. Nephrosclerosis patients should talk to their nephrologist in order to optimally adapt their lives to the disease, which is usually associated with numerous restrictions. If kidney failure occurs as a result of the disease, the emergency medical services must be called. The patient should lie down quietly and take the emergency medication if available.
