Kidney pressure: symptoms and treatment
Jun 06, 2018
Renal hypertension is a pathological condition characterized by an increase in arterial pressure in the presence of kidney vessels.As a rule, this type of hypertension is poorly adjusted by special medications, many patients require stenting, shunting and other surgical interventions on the kidney vessels.Table of Contents: Reasons for Renal Pressure Symptoms of Renal Pressure Treatment of Renal Pressure
Reasons for Renal Pressure
This disease occurs because of the narrowing of arteries that deliver blood to the kidneys.Moreover, the vessels leading to both the right and left kidneys may be narrowed, in some cases stenosis of the renal artery is diagnosed - a condition in which the vessels that deliver blood to both kidneys are narrowed at once.
If small amounts of blood enter the kidneys, they begin to work on the algorithm of "dehydration", making water reserves.The result is a significant increase in circulating blood, which leads to increased blood pressure.Against the background of small amounts of blood in the kidneys, special substances are beginning to be produced, which cause a prolonged and severe constriction of the vessels.
Please note! Stenosis of the renal arteries often occurs against the background of atherosclerosis, such a pathological condition can lead to coronary artery occlusion and a heart attack.It is extremely rare, but there is fibromuscular dysplasia - a disease associated with improper formation of the renal arteries even at the stage of intrauterine development of the fetus.
Symptoms of renal pressure
Most often the disease under consideration does not manifest itself at all - stenosis of vessels can not be felt, and high blood pressure does not always give symptoms.The signs of renal hypertension appear only if the blood pressure indicators become dangerously high. These characteristics include:
- nasal bleeding;
- presence of blood in the urine;
- visual impairment( "flies", double image, vagueness).
Most people are not at all familiar with the listed symptoms, but this is the danger of renal hypertension - the absence of symptoms against the background of constantly high renal pressure causes irreparable harm to internal organs.
This pathology can lead to the progression of chronic renal failure, which is manifested by a decrease in the functionality of the kidneys.And until the complication becomes too serious, the patients do not experience any symptoms.Renal hypertension may be suspected by a doctor only if the patient regularly has an increase in blood pressure, but even the most powerful antihypertensive medications do not have the proper effect.
Treatment of renal pressure
Of course, therapy for identifying renal hypertension is selected individually, but there are general guidelines for prescribing:
- Captopril, Lysinopril, Ramipril, Enalapril.These drugs, which belong to the group of angiotensin-converting enzyme inhibitors, are prescribed only for stenosis of one or two concurrent renal arteries.
Note: if the patient has only one kidney and is diagnosed with renal artery stenosis, then these medications are contraindicated for use.
- Valsartan, Lozartan, Candesartan.Relate to the group of angiotensin receptor blockers, are prescribed only with stenosis of one of the two renal arteries.These drugs can be used in the treatment of renal pressure only if the patient is under constant medical supervision - you will need to monitor the kidneys, in particular, regularly determine the level of creatinine in the blood.
- Amlodipine, Felodipine.These drugs belong to the group of calcium antagonists, they are most often chosen by doctors in the treatment of renal pressure.In many cases, monotherapy is ineffective, so calcium antagonists are prescribed concomitantly with diuretics, beta-blockers and other drugs.Most often, for the treatment of renal hypertension, doctors prescribe 4-5 drugs at the same time.
- Satines.They are prescribed only for arteriosclerosis atherosclerosis, when it is necessary to reduce the rate of progression of this pathological condition and to lower the level of cholesterol in the blood.
If conservative methods of treatment do not give positive results, then specialists refer patients to surgical treatment.
In medicine, three types of surgical interventions are used to treat renal pressure:
- Angioplasty.This type of surgical treatment consists in the introduction of a catheter through a large artery( more often the femoral is used for this) and carrying it to the narrowed renal artery.Then the doctor inflates the balloon, which is located at the end of the catheter - he "pushes" the walls of the artery, restores its lumen and blood begins to enter the kidneys in the proper volume.
- Stenting.This procedure begins as well as the previous one - the catheter is inserted through the femoral artery and advances to the narrowed artery of the kidneys.At the end of the catheter there is no balloon, the "stent" is delivered to the special stent, which is covered with a drug substance.Often, doctors, conducting surgical intervention for the treatment of renal hypertension, combine angioplasty and stenting, and according to statistics the latter type of treatment is more effective.
Please note: angioplasty and stenting refer to minimally invasive methods of surgical treatment of the pathology in question - recovery of the patient takes place in a short time, complications in the early and late postoperative period are practically absent.
- Bypass operation.If the above described methods of surgical treatment can not be carried out, or they do not have the proper effect, then doctors conduct shunting.During the operation, the specialist applies an anastomosis so that the blood enters the kidney along the normal arteries.It turns out that the narrowed vessels are excluded from the blood stream.The operation of shunting in renal hypertension is identical to that performed by surgeons on the heart with the risk of developing a heart attack due to narrowed coronary arteries.
In most cases, patients who underwent surgical treatment, blood pressure indicators come back to normal.Some patients are cured completely, they are abolished the use of antihypertensive drugs.It is generally believed that surgical intervention is the most effective method of treating renal pressure, since the effect is directly on the damaged narrowed vessels.In terms of effectiveness, the first place is occupied by the bypass operation, in the second place - stenting.
Important! The prognosis for renal pressure is usually favorable, but only if the patient has turned in time for qualified medical care.Any of the methods of treatment is more effective if the patient is diagnosed with stenosis of only one renal artery.
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category