Marín R, Gorostidi M, Pobes A
Servicio de Nefrología, Hospital Covadonga, Oviedo, Asturias.
Nefrologia. 2002;22 Suppl 1:36-45.
Nephroangiosclerosis and nephrosclerosis are terms used to define the renal disease induced by essential hypertension. The predominant histologic changes occur in the preglomerular microvasculature. Epidemiological data about the risk of hypertensive patients from developing renal failure offer conflicting results. Nevertheless, renal vascular disease, including nephroangiosclerosis and/or ischemic nephropathy, appears to be an important cause of end-stage renal disease. Presumably, nephrosclerosis is the renal expression of systemic atherosclerosis: male sex, age > 55-60 years, black race, high serum cholesterol and/or uric acid levels, and coronary heart disease, peripheral artery disease, and/or cerebrovascular disease are common associations with the renal alteration. Treatment strategy should include an intensive blood pressure control, probably below 130/80 mmHg, together with antiplatelet and lipid-lowering agents when necessary. Although specific studies are lacking, ACE inhibitors and angiotensin II antagonists may offer additional benefits in slowing the renal disease progression.
肾血管硬化症和肾硬化症是用于定义由原发性高血压引起的肾脏疾病的术语。主要的组织学变化发生在肾小球前微血管系统。关于高血压患者发生肾衰竭风险的流行病学数据结果相互矛盾。然而，肾血管疾病，包括肾血管硬化症和/或缺血性肾病，似乎是终末期肾病的一个重要原因。据推测，肾硬化症是全身性动脉粥样硬化在肾脏的表现：男性、年龄>55 - 60岁、黑人种族、高血清胆固醇和/或尿酸水平，以及冠心病、外周动脉疾病和/或脑血管疾病常与肾脏改变相关。治疗策略应包括强化血压控制，可能要低于130/80 mmHg，必要时联合使用抗血小板和降脂药物。尽管缺乏具体研究，但血管紧张素转换酶抑制剂和血管紧张素II拮抗剂在减缓肾脏疾病进展方面可能会带来额外益处。
