【用戶】.

【年級】大三上

【評論內容】Hypertensive nephrosclerosis在pathological findings分為3類討論:vascular, glomerular and tubulointerstitialVascular: medial hypertrophy, fibroblastic intimal thickening of large and small renal arteries and glomerular arterioles leading to narrowing of the vascular lumen.Glomerulosclerosis: focal global and focal segmental sclerosis. (ischemic injury leading to nephron loss, glomerular enlargement)Tubulointerstitial: interstitial fibrosis and tubular atrophy (animal studies: favored related to severe stenosis of the main renal artery and ischemic kidney)    另外在於glomerular hemodynamics in progressive renal disease有兩項發現:Among initially untreated patients with mild hypertension, an elevated creatinine clearance (suggestive of glomerular hyperfiltration) at baseline has been related to a subsequent significant rise in the plasma creatinine concentration and higher blood pressure levels and to the development of moderately increased albuminuria (formerly called "microalbuminuria").Part of the enhanced risk in black patients may be related to maternal malnutrition, leading to low birth weight, impaired renal development, and a reduction in nephron number. The decrease in the number of nephrons results in compensatory hypertrophy in the nephrons that are present and subsequent glomerulosclerosis. The way by which the variants on the apolipoprotein 1 (APOL1) gene are translated into renal physiology has not been elucidated