Prognosis of Hypertensive Nephropathy
Benign nephrosclerosis:As the name suggests, this condition will rarely result in renal failure. Patients who develop this condition will have decreased renal reserve and may not cope very well with acute illness and surgical procedures. Between 1-5% of patients with this condition with develop renal failure at some stage in the disease process.Malignant nephrosclerosis:With modern therapy, 75% of patients are able to survive more then five years from the onset of disease. The earlier that treatment is initiated, the more kidney will be preserved and the greater the renal function on resolution of the condition.
How is Hypertensive Nephropathy Treated?
Control of hypertension is central to the management of both malignant and benign forms of the disease. This is achieved using antihypertension medication to essentially remove the stimulus for further kidney damage. The importance of antihypertension medication must be stressed to improve compliance to antihypertensive therapy. In the case of malignant nephrosclerosis, efforts to reduce blood pressure must be more aggressive as the renal damage is accelerated in this form of disease. Admission to hospital is the rule and intravenous drugs may be used to hasten the reduction of blood pressure and thereby quickly prevent any further renal damage from occurring. Aggressive reduction of blood pressure – Use of drugs such as frusemide, thiazide diuretics and hydralazine will rapidly reduce blood pressure and may save renal function if used early enough. In many cases, the patient may develop renal failure that required close observation with many blood tests. Of the acute renal failure cannot be controlled by conservative means, then dialysis may be required to enable eventual recovery from the disease.