hypertension in the clinic is extremely common. In general, it can be pided into two categories: essential hypertension and secondary hypertension. Renal hypertension is one of the most common secondary hypertension, in patients with no obvious edema or no urine examination, the patient is thought to be the primary hypertension. There are great differences in the treatment and prognosis of renal hypertension and essential hypertension, so it is necessary to make a careful identification of the two. So how to distinguish between renal hypertension and essential hypertension, which requires careful examination and medical history, a causal relationship, to clarify the order of onset. Renal hypertension can be pided into renal parenchymal hypertension and renovascular hypertension. Renal parenchymal hypertension, in the case of atypical cases, and the identification of primary hypertension has some difficulties, then need to do a clear diagnosis of kidney.
(1) renal hypertension: this kind of patients with kidney disease, such as acute nephritis, chronic nephritis, nephrotic syndrome and chronic pyelonephritis.
(2) primary hypertension: generally older, or have a family history of essential hypertension, high blood pressure, kidney damage after. Such as proteinuria and renal insufficiency.
(3) renal vascular hypertension: more common in patients under the age of 30, or over the age of 55, a sudden occurrence of malignant hypertension, or a history of high blood pressure in the past, suddenly turned to malignant hypertension. And should pay attention to whether there is a history of trauma in the waist, waist and back or flank pain, abdominal pain and other medical history. Physical examination of the abdomen or flank, the neck may have vascular murmur. However, none of the above features are specific. The diagnosis depends on renal arteriography and renal vein renin.