腎硬化症
WordNet
- kidney disease that is usually associated with hypertension; sclerosis of the renal arterioles reduces blood flow that can lead to kidney failure and heart failure (同)nephroangiosclerosis
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/09/12 16:05:58」(JST)
[Wiki en表示]
Hypertensive nephropathy |
Classification and external resources |
Micrograph showing renal arterial hyalinosis - pink ring right-of-centre. PAS stain.
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ICD-10 |
I12 |
ICD-9 |
403 |
Hypertensive nephropathy (or "hypertensive nephrosclerosis", or "Hypertensive renal disease") is a medical condition referring to damage to the kidney due to chronic high blood pressure. It should be distinguished from "renovascular hypertension" (I15.0), which is a form of secondary hypertension.
In the kidneys, as a result of benign arterial hypertension, hyaline (pink, amorphous, homogeneous material) accumulates in the wall of small arteries and arterioles, producing the thickening of their walls and the narrowing of the lumina — hyaline arteriolosclerosis. Consequent ischemia will produce tubular atrophy, interstitial fibrosis, glomerular alterations (smaller glomeruli with different degrees of hyalinization - from mild to sclerosis of glomeruli) and periglomerular fibrosis. In advanced stages, renal failure will occur. Functional nephrons have dilated tubules, often with hyaline casts in the lumens. Additional complications often associated with hypertensive nephropathy include glomerular damage resulting in proteinuria and hematuria.
See also
External links
- Photo at Atlas of Pathology
- Tylicki L, Rutkowski B (2003). "[Hypertensive nephropathy: pathogenesis, diagnosis and treatment]". Pol. Merkur. Lekarski (in Polish) 14 (80): 168–73. PMID 12728683.
- Luft FC (October 2000). "Hypertensive nephrosclerosis-a cause of end-stage renal disease?". Nephrol Dial Transplant. 15 (10): 1515–7. doi:10.1093/ndt/15.10.1515. PMID 11007815.
- Cardiovascular disease: vascular disease
- Circulatory system pathology
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Arteries, arterioles
and capillaries |
Inflammation
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- Arteritis
- Buerger's disease
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Arterial occlusive disease /
peripheral vascular disease
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Arteriosclerosis
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- Atherosclerosis
- Foam cell
- Fatty streak
- Atheroma
- Intermittent claudication
- Monckeberg's arteriosclerosis
- Arteriolosclerosis
- Hyaline
- Hyperplastic
- Cholesterol
- LDL
- Oxycholesterol
- Trans fat
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Stenosis
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- Carotid artery stenosis
- Renal artery stenosis
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Other
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- Aortoiliac occlusive disease
- Degos disease
- Erythromelalgia
- Fibromuscular dysplasia
- Raynaud's phenomenon
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Aneurysm / dissection /
pseudoaneurysm
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- torso: Aortic aneurysm
- Abdominal aortic aneurysm
- Thoracic aortic aneurysm
- Aortic dissection
- Coronary artery aneurysm
- head / neck
- Intracranial aneurysm
- Intracranial berry aneurysm
- Carotid artery dissection
- Vertebral artery dissection
- Familial aortic dissection
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Vascular malformation
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- Arteriovenous fistula
- Arteriovenous malformation
- Telangiectasia
- Hereditary hemorrhagic telangiectasia
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Vascular nevus
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- Cherry hemangioma
- Halo nevus
- Spider angioma
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Veins |
Inflammation
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Venous thrombosis /
Thrombophlebitis
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- primarily lower limb
- abdomen
- Hepatic veno-occlusive disease
- Budd–Chiari syndrome
- May–Thurner syndrome
- Portal vein thrombosis
- Renal vein thrombosis
- upper limb / torso
- Mondor's disease
- Paget–Schroetter disease
- head
- Cerebral venous sinus thrombosis
- Post-thrombotic syndrome
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Varicose veins
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- Gastric varices
- Portacaval anastomosis
- Caput medusae
- Esophageal varices
- Hemorrhoid
- Varicocele
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Other
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- Chronic venous insufficiency
- Chronic cerebrospinal venous insufficiency
- Superior vena cava syndrome
- Inferior vena cava syndrome
- Venous ulcer
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Arteries or veins |
- Angiopathy
- Macroangiopathy
- Microangiopathy
- Embolism
- Pulmonary embolism
- Cholesterol embolism
- Paradoxical embolism
- Thrombosis
- Vasculitis
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Blood pressure |
Hypertension
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- Hypertensive heart disease
- Hypertensive emergency
- Hypertensive nephropathy
- Essential hypertension
- Secondary hypertension
- Renovascular hypertension
- Benign hypertension
- Pulmonary hypertension
- Systolic hypertension
- White coat hypertension
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Hypotension
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anat (a:h/u/t/a/l,v:h/u/t/a/l)/phys/devp/cell/prot
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noco/syva/cong/lyvd/tumr, sysi/epon, injr
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proc, drug (C2s+n/3/4/5/7/8/9)
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- Urinary system
- Pathology
- Urologic disease / Uropathy (N00–N39, 580–599)
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Abdominal |
Nephropathy/
(nephritis+
nephrosis) |
Glomerulopathy/
glomerulitis/
(glomerulonephritis+
glomerulonephrosis) |
Primarily
nephrotic |
Non-proliferative |
- Minimal change
- Focal segmental
- Membranous
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Proliferative |
- Mesangial proliferative
- Endocapillary proliferative
- Membranoproliferative/mesangiocapillary
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By condition |
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Primarily
nephritic,
RPG |
Type I RPG/Type II hypersensitivity |
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Type II RPG/Type III hypersensitivity |
- Post-streptococcal
- Lupus
- IgA/Berger's
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Type III RPG/Pauci-immune |
- Granulomatosis with polyangiitis
- Microscopic polyangiitis
- Churg–Strauss syndrome
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Tubulopathy/
tubulitis |
Proximal |
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Thick ascending |
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Distal convoluted |
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Collecting duct |
- Liddle's syndrome
- RTA
- Diabetes insipidus
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Renal papilla |
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Major calyx/pelvis |
- Hydronephrosis
- Pyonephrosis
- Reflux nephropathy
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Any/all |
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Interstitium |
- Interstitial nephritis
- Pyelonephritis
- Danubian endemic familial nephropathy
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Any/all |
General syndromes |
- Renal failure
- Acute renal failure
- Chronic kidney disease
- Uremic pericarditis
- Uremia
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Vascular |
- Renal artery stenosis
- Renal ischemia
- Hypertensive nephropathy
- Renovascular hypertension
- Renal cortical necrosis
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Other |
- Analgesic nephropathy
- Renal osteodystrophy
- Nephroptosis
- Abderhalden–Kaufmann–Lignac syndrome
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Ureter |
- Ureteritis
- Ureterocele
- Megaureter
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Pelvic |
Bladder |
- Cystitis
- Interstitial cystitis
- Hunner's ulcer
- Trigonitis
- Hemorrhagic cystitis
- Neurogenic bladder dysfunction
- Bladder sphincter dyssynergia
- Vesicointestinal fistula
- Vesicoureteral reflux
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Urethra |
- Urethritis
- Non-gonococcal urethritis
- Urethral syndrome
- Urethral stricture/Meatal stenosis
- Urethral caruncle
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Any/all |
- Obstructive uropathy
- Urinary tract infection
- Retroperitoneal fibrosis
- Urolithiasis
- Bladder stone
- Kidney stone
- Renal colic
- Malakoplakia
- Urinary incontinence
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noco/acba/cong/tumr, sysi/epon, urte
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proc/itvp, drug (G4B), blte, urte
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UpToDate Contents
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English Journal
- Prevalence of Fabry disease in dialysis patients: Japan Fabry disease screening study (J-FAST).
- Saito O1, Kusano E, Akimoto T, Asano Y, Kitagawa T, Suzuki K, Ishige N, Akiba T, Saito A, Ishimura E, Hattori M, Hishida A, Guili C, Maruyama H, Kobayashi M, Ohashi T, Matsuda I, Eto Y.
- Clinical and experimental nephrology.Clin Exp Nephrol.2015 Jul 22. [Epub ahead of print]
- BACKGROUND: In Fabry disease, progressive glycolipid accumulation leads to damage in kidney and other organs. This study was designed to determine the prevalence rate of Fabry disease in Japanese dialysis patients.METHODS: All dialysis patients agreeing to Japan Fabry disease screening study (J-FAST
- PMID 26197777
- Intrarenal and Urinary Th9 and Th22 Cytokine Gene Expression in Lupus Nephritis.
- Luk CC1, Tam LS1, Kwan BC1, Wong PC1, Ma TK1, Chow KM1, Lai FM1, Li PK1, Szeto CC2.
- The Journal of rheumatology.J Rheumatol.2015 Jul;42(7):1150-5. doi: 10.3899/jrheum.140954. Epub 2015 May 15.
- OBJECTIVE: We studied the urinary sediment mRNA level of Th9- and Th22-related cytokines in patients with systemic lupus erythematosus (SLE).METHODS: We quantified urinary mRNA levels of interleukin (IL) 9, IL-10, IL-22, and their corresponding transcription factors in 73 patients with active lupus
- PMID 25979722
- Patients with biopsy-proven nephrosclerosis and moderately impaired renal function have a higher risk for cardiovascular disease: 15 years' experience in a single, kidney disease center.
- Suzuki H1, Kobayashi K2, Ishida Y2, Kikuta T2, Inoue T2, Hamada U3, Okada H2.
- Therapeutic advances in cardiovascular disease.Ther Adv Cardiovasc Dis.2015 Jun;9(3):77-86. doi: 10.1177/1753944715578596. Epub 2015 Apr 1.
- BACKGROUND: Nephrosclerosis progresses slowly to end-stage renal disease (ESRD) in only a small percentage of patients. However, because hypertension and nephrosclerosis are normally found simultaneously, nephrosclerosis is a risk factor for cardiovascular disease (CVD). In turn, the onset of CVD ma
- PMID 25838316
Japanese Journal
- 糖尿病性腎症と高血圧性腎硬化症の病理診断への手引き
- 佐藤 博,鈴木 芳樹,北村 博司 [他]
- The Japanese journal of nephrology = 日本腎臓学会誌 57(4), 649-725, 2015
- NAID 40020503067
- 保存的治療にて救命し得たラミブジン誘発横紋筋融解症合併B型慢性肝炎急性増悪の1例
- 林 秀美,澤田 康司,長谷部 拓夢 [他],中嶋 駿介,阿部 真美,細木 弥生,大竹 孝明,藤井 常志,藤谷 幹浩,高後 裕,長谷部 千登美
- 肝臓 56(7), 341-347, 2015
- 症例は50歳,男性.2006年頃からB型慢性肝炎,脂質異常症,腎硬化症,高血圧,痛風で近医に通院していたが,抗ウイルス療法は施行されていなかった.2014年2月から肝機能障害の悪化を認め,2014年4月に全身倦怠感が出現し,B型慢性肝炎急性増悪と診断された.エンテカビル投与後に腎機能障害を認めたため,ラミブジン(LAM)投与に変更,15日後にaspartate aminotransferase(A …
- NAID 130005090877
- 高血圧性腎硬化症 (第5土曜特集 腎臓病のすべて) -- (腎臓病各論 : 診断とエビデンスに基づいた治療)
Related Links
- Nephrosclerosis. According to the 2011 US Renal Data System (USRDS) data, in the year 2009, hypertensive nephrosclerosis (HN) accounted for 28% of patients reaching end-stage renal disease (ESRD). ... According ...
- Background According to the 2011 US Renal Data System (USRDS) data, in the year 2009, hypertensive nephrosclerosis (HN) accounted for 28% of patients reaching end-stage renal disease (ESRD). The rate of ESRD attributed to ...
Related Pictures
★リンクテーブル★
[★]
- 英
- nephrosclerosis
- 関
- [[]]
概念
- 腎血管病変に伴う血流障害の結果、糸球体の硬化・硝子化、尿細管萎縮、間質結合組織の増加を来し、腎が硬化した状態。
分類
比較
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動脈性腎硬化症
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良性腎硬化症
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悪性腎硬化症
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老人性腎硬化症
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原疾患
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粥状硬化症
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高血圧
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悪性高血圧症がほとんど
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病理
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腎動脈やその分枝などの粥状硬化 内腔の狭小化や内膜断裂 腎組織は虚血性の萎縮像
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小細動脈硬化(細動脈硬化)による内腔の狭窄とその灌流域のネフロンの萎縮 小葉間動脈や糸球体輸入動脈に硬化が見られる (⇔糖尿病性の場合には輸出細動脈にも認められる) 硝子様細動脈硬化、線維増殖性内膜肥厚 病変の進行と共に腎萎縮 腎表面は細顆粒状
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腎の細動脈にフィブリノイド壊死と増殖性動脈内膜炎
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腎機能
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健常な腎実質が残存
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腎機能は軽度~中等度で、比較的末期まで腎機能は保たれる
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高度の腎機能低下が急速に進展
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検査
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(細動脈性腎硬化症)タンパク尿:軽度(1日1g以上はまれ)。尿沈渣:正常~軽微な変化
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