Treatment of Nephrosclerosis

About the disease

Nephrosclerosis is a condition whereby the kidneys are damaged by chronic hypertension (suffering from high blood pressure for a long period of time). This causes the walls of the renal artery to become hardened and congested. People with diabetes are more prone to high blood pressure, and are therefore also more prone to kidney problems. If not treated in time, nephrosclerosis can lead to renal failure, which can be fatal.

According to Britannica.com, there are two types of nephrosclerosis: benign and malignant. At first the smaller blood vessels are affected, followed by the larger ones, and so on. Over time, the whole wall of the renal artery can thicken, causing the supply of blood to the kidney to become blocked. This is when symptoms usually start to appear.

In benign nephrosclerosis, the hardening of the artery walls takes a very long time: the process can last for decades before manifesting itself. If the blockage is complete, which is rare, there is a high risk of renal failure. In malignant nephrosclerosis, the artery walls also harden and thicken, but at a much quicker pace. In some cases the process of deterioration can take mere days and results in a medical emergency, requiring immediate hospitalization.

Symptoms

• Nausea
• Vomiting
• Weight loss
• Lack of appetite
• Drowsiness
• Confusion
• Foul taste in the mouth
• Blood in the urine, in severe cases
• Painful urination, in some cases
• Changes in the retina

Diagnosis

• During a general examination, the doctor will ask the patient how long they have suffered from high blood pressure and what caused it.
• The doctor will also ask about the symptoms listed above, to determine whether high blood pressure could be having a detrimental effect on the kidneys.
• Changes in the retina can indicate kidneys problems in people with high blood pressure, so the doctor might also examine the patient’s eyes.
• A blood test and urinalysis are helpful in determining the extent of damage to the kidneys. A urinalysis can also rule out a kidney infection.
• Imaging tests, such as an ultrasound, can display the damage to the kidney and also determine the stage of nephrosclerosis.

Treatment

• Conservative treatment, such as the prescription of blood pressure medications, can normalize the patient’s blood pressure and prevent the hardening of the artery walls.
• A laparoscopic nephrectomy is a surgical procedure whereby a damaged kidney is removed if it cannot be repaired. This surgery is required if there is a very high risk of renal failure or if it has already happened.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko