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subsection</span> </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Histology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Histology"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Histology</span> </div> </a> <ul id="toc-Histology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Urine_test" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Urine_test"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Urine test</span> </div> </a> <ul id="toc-Urine_test-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Definitive_diagnosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Definitive_diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Definitive diagnosis</span> </div> </a> <ul id="toc-Definitive_diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Future_diagnostic_approaches" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Future_diagnostic_approaches"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.4</span> <span>Future diagnostic approaches</span> </div> </a> <ul id="toc-Future_diagnostic_approaches-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Management</span> </div> </a> <ul id="toc-Management-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Hypertensive kidney disease</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 13 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-13" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">13 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AF%D8%A7%D8%A1_%D9%83%D9%84%D9%88%D9%8A_%D8%A8%D9%81%D8%B1%D8%B7_%D8%B6%D8%BA%D8%B7_%D8%A7%D9%84%D8%AF%D9%85" title="داء كلوي بفرط ضغط الدم – Arabic" lang="ar" hreflang="ar" data-title="داء كلوي بفرط ضغط الدم" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Nephrosklerose" title="Nephrosklerose – German" lang="de" hreflang="de" data-title="Nephrosklerose" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Nefropat%C3%ADa_hipertensiva" title="Nefropatía hipertensiva – Spanish" lang="es" hreflang="es" data-title="Nefropatía hipertensiva" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/N%C3%A9phroangioscl%C3%A9rose" title="Néphroangiosclérose – French" lang="fr" hreflang="fr" data-title="Néphroangiosclérose" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B3%A0%ED%98%88%EC%95%95%EC%84%B1_%EC%8B%A0%EC%9E%A5_%EC%A7%88%ED%99%98" title="고혈압성 신장 질환 – Korean" lang="ko" hreflang="ko" data-title="고혈압성 신장 질환" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%86%D5%A5%D6%86%D6%80%D5%B8%D5%BD%D5%AF%D5%AC%D5%A5%D6%80%D5%B8%D5%A6" title="Նեֆրոսկլերոզ – Armenian" lang="hy" hreflang="hy" data-title="Նեֆրոսկլերոզ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Nefroangiosclerosi_benigna" title="Nefroangiosclerosi benigna – Italian" lang="it" hreflang="it" data-title="Nefroangiosclerosi benigna" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%9D%D0%B5%D1%84%D1%80%D0%BE%D1%81%D0%BA%D0%BB%D0%B5%D1%80%D0%BE%D0%B7" title="Нефросклероз – Kazakh" lang="kk" hreflang="kk" data-title="Нефросклероз" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%9D%D0%B5%D1%84%D1%80%D0%BE%D1%81%D0%BA%D0%BB%D0%B5%D1%80%D0%BE%D0%B7" title="Нефросклероз – Kyrgyz" lang="ky" hreflang="ky" data-title="Нефросклероз" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Nefropatia_hipertensiva" title="Nefropatia hipertensiva – Portuguese" lang="pt" hreflang="pt" data-title="Nefropatia hipertensiva" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9D%D0%B5%D1%84%D1%80%D0%BE%D1%81%D0%BA%D0%BB%D0%B5%D1%80%D0%BE%D0%B7" title="Нефросклероз – Russian" lang="ru" hreflang="ru" data-title="Нефросклероз" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9D%D0%B5%D1%84%D1%80%D0%BE%D1%81%D0%BA%D0%BB%D0%B5%D1%80%D0%BE%D0%B7" title="Нефросклероз – Ukrainian" lang="uk" hreflang="uk" data-title="Нефросклероз" 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data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Hypertensive kidney disease</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Hypertensive nephrosclerosis (HN or HNS), hypertensive kidney disease, hypertensive nephropathy (HN), nephroangiosclerosis<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4b/Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg/220px-Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4b/Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg/330px-Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4b/Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg/440px-Renal_arterial_hyalinosis_-_pas_-_very_high_mag.jpg 2x" data-file-width="4272" data-file-height="2848" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> showing renal arterial hyalinosis – pink ring right-of-centre. <a href="/wiki/PAS_stain" class="mw-redirect" title="PAS stain">PAS stain</a>.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Nephrology" title="Nephrology">Nephrology</a> <span class="penicon autoconfirmed-show"><span class="mw-valign-text-top" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q1434446?uselang=en#P1995" title="Edit this on Wikidata"><img alt="Edit this on Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></td></tr></tbody></table> <p><b>Hypertensive kidney disease</b> is a medical condition referring to damage to the <a href="/wiki/Kidney" title="Kidney">kidney</a> due to chronic <a href="/wiki/High_blood_pressure" class="mw-redirect" title="High blood pressure">high blood pressure</a>. It manifests as <b>hypertensive nephrosclerosis</b> (sclerosis referring to the stiffening of renal components).<sup id="cite_ref-auto1_2-0" class="reference"><a href="#cite_note-auto1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> It should be distinguished from <a href="/wiki/Renovascular_hypertension" title="Renovascular hypertension">renovascular hypertension</a>, which is a form of <a href="/wiki/Secondary_hypertension" title="Secondary hypertension">secondary hypertension</a>, and thus has opposite direction of causation. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Signs and symptoms of <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a>, including loss of appetite, <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Itch" title="Itch">itching</a>, sleepiness or confusion, weight loss, and an unpleasant taste in the mouth, may develop.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=2" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Gross_pathology_of_nephrosclerosis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c8/Gross_pathology_of_nephrosclerosis.jpg/220px-Gross_pathology_of_nephrosclerosis.jpg" decoding="async" width="220" height="169" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c8/Gross_pathology_of_nephrosclerosis.jpg/330px-Gross_pathology_of_nephrosclerosis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c8/Gross_pathology_of_nephrosclerosis.jpg/440px-Gross_pathology_of_nephrosclerosis.jpg 2x" data-file-width="875" data-file-height="673" /></a><figcaption>On <a href="/wiki/Gross_pathology" title="Gross pathology">gross pathology</a>, nephrosclerosis manifests as a fine granular surface.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>"Hypertensive" refers to high blood pressure and "nephropathy" means damage to the kidney; hence this condition is where chronic high blood pressure causes damages to kidney tissue; this includes the small blood vessels, glomeruli, kidney tubules and interstitial tissues. The tissue hardens and thickens which is known as nephrosclerosis.<sup id="cite_ref-auto1_2-1" class="reference"><a href="#cite_note-auto1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The narrowing of the blood vessels means less blood is going to the tissue and so less oxygen is reaching the tissue resulting in tissue death (ischemia).<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Risk factors for HN include poorly controlled, moderate-to-severe hypertension, older age, other kidney disorders, and Afro-Caribbean background, whose exact cause is unclear, as it may be due to either genetic susceptibility or poor health management among people of Afro-Caribbean descent.<sup id="cite_ref-auto1_2-2" class="reference"><a href="#cite_note-auto1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=3" title="Edit section: Mechanism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the kidneys, as a result of <i>benign <a href="/wiki/Arterial_hypertension" class="mw-redirect" title="Arterial hypertension">arterial hypertension</a></i>, <a href="/wiki/Hyaline" title="Hyaline">hyaline</a> (pink, amorphous, homogeneous material) accumulates in the walls of small arteries and arterioles, producing the thickening of their walls and the narrowing of the <a href="/wiki/Lumen_(anatomy)" title="Lumen (anatomy)">arterial openings</a>, a process known as <a href="/wiki/Arteriolosclerosis" title="Arteriolosclerosis">arteriolosclerosis</a>. The resulting <a href="/wiki/Ischemia" title="Ischemia">inadequate blood flow</a> produces <a href="/w/index.php?title=Tubular_atrophy&action=edit&redlink=1" class="new" title="Tubular atrophy (page does not exist)">tubular atrophy</a>, <a href="/w/index.php?title=Interstitial_fibrosis&action=edit&redlink=1" class="new" title="Interstitial fibrosis (page does not exist)">interstitial fibrosis</a>, and glomerular alterations (smaller <a href="/wiki/Glomerulus_(kidney)" title="Glomerulus (kidney)">glomeruli</a> with different degrees of hyalinization – from mild to sclerosis of glomeruli) and scarring around the glomeruli (periglomerular fibrosis). In advanced stages, <a href="/wiki/Kidney_failure" title="Kidney failure">kidney failure</a> will occur. Functional nephrons<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> have dilated tubules, often with hyaline <a href="/wiki/Urinary_casts" class="mw-redirect" title="Urinary casts">casts</a> in the opening of the tubules. Additional complications often associated with hypertensive nephropathy include glomerular damage resulting in <a href="/wiki/Proteinuria" title="Proteinuria">protein</a> and <a href="/wiki/Hematuria" title="Hematuria">blood in the urine</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2021)">citation needed</span></a></i>]</sup> </p><p>Hypertensive nephropathy refers to kidney failure that can be attributed to a history of hypertension<sup id="cite_ref-medscape_7-0" class="reference"><a href="#cite_note-medscape-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> It is a chronic condition and it is a serious risk factor for the development of end-stage kidney disease (ESKD). However, despite the well-known association between hypertension and chronic kidney disease, the underlying mechanism remains unclear. The two proposed mechanisms of HN's pathophysiology<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> both centre around how the glomerulus, a network of dense capillaries that carries out the kidney filtration process, is affected; with one theory identifying glomerular ischemia as the main contributor to HN and the other identifying glomerular hypertension and glomerular hyperfiltration at the centre of HN's pathogenesis.<sup id="cite_ref-medscape_7-1" class="reference"><a href="#cite_note-medscape-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Glomerular_ischemia">Glomerular ischemia</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=4" title="Edit section: Glomerular ischemia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>High blood pressure in the long term can damage the <a href="/wiki/Endothelium" title="Endothelium">endothelium</a>, commonly known as the blood vessel lining. This leads to a build-up of plaques and they can be deposited in the renal arteries causing stenosis and ischemic kidney disease.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2016)">citation needed</span></a></i>]</sup> In this situation, the kidney supplied blood by the narrowed renal artery suffers from inadequate blood flow, which in turn causes the size of the kidneys to decrease. Other consequences include arterial stiffening, which involves a gradual breakdown of elastic fibers and intima (the innermost layer of a blood vessel) thickening.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2016)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Glomerular_hypertension_and_glomerular_hyperfiltration">Glomerular hypertension and glomerular hyperfiltration</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=5" title="Edit section: Glomerular hypertension and glomerular hyperfiltration"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>An alternative mechanism of hypertensive nephropathy is prolonged glomerular hypertension and hence glomerular hyperfiltration. These can occur simultaneously but not necessarily. The idea is that hypertension results in sclerosis of the glomeruli which ultimately means reduced kidney function. As a compensatory mechanism, the unaffected nephrons (specifically, the preglomerular arterioles) vasodilate to increase blood flow to the kidney perfusion and increase glomerular filtration across undamaged glomeruli.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=6" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Diagnosis of HN is made from clinical history and biochemical investigations. Chronic hypertension with progressive kidney disease progresses over a long period of time. Damage to the glomeruli allows proteins that are usually too large to pass into the <a href="/wiki/Nephron" title="Nephron">nephron</a> to be filtered. This leads to an elevated concentration of albumin in the urine (albuminuria). This albuminuria usually does not cause symptoms but can be indicative of <a href="/wiki/Albuminuria#Causes" title="Albuminuria">many kidney disorders</a>. Protein in the urine (proteinuria) is best identified from a 24-hour urine collection.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Bilateral renal artery stenosis should always be considered as a differential diagnosis for the presentation of HN. Kidney disease with this etiology can potentially be reversed following vascular intervention.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Histology">Histology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=7" title="Edit section: Histology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In benign nephrosclerosis, the changes occurring are gradual and progressive, however, there can be sufficient kidney reserve capacity to maintain adequate kidney function for many years.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> The large renal arteries exhibit <a href="/wiki/Tunica_intima" title="Tunica intima">intimal</a> thickening, <a href="/wiki/Tunica_media" title="Tunica media">medial</a> hypertrophy, duplication of the elastic layer. The changes in small arterioles include hyaline arteriolosclerosis (deposition of <a href="/wiki/Hyaline" title="Hyaline">hyaline</a>, collagenous material),<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2019)">citation needed</span></a></i>]</sup> which causes glomerular collapse (wrinkling and thickening of <a href="/wiki/Basement_membrane" title="Basement membrane">capillary basement membranes</a> and collapse of capillary lumen) and solidification (glomeruli exhibit <a href="/wiki/Sclerosis_(medicine)" title="Sclerosis (medicine)">sclerosis</a> and increase in <a href="/wiki/Mesangium" class="mw-redirect" title="Mesangium">mesangial</a> matrix). The degree of scarring correlates with the degree of <a href="/wiki/Renal_function" class="mw-redirect" title="Renal function">glomerular filtration</a> deficit.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2021)">citation needed</span></a></i>]</sup> </p> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 199.33333333333px"> <div class="thumb" style="width: 197.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_hypertensive_glomerular_lesion_of_hypertensive_nephropathy.jpg" class="mw-file-description" title="Light micrograph showing hypertensive glomerular lesion of hypertensive nephropathy: global glomerular collapse and filling of Bowman's space with a lightly staining collagenous material."><img alt="Light micrograph showing hypertensive glomerular lesion of hypertensive nephropathy: global glomerular collapse and filling of Bowman's space with a lightly staining collagenous material." src="//upload.wikimedia.org/wikipedia/commons/thumb/6/63/Histopathology_of_hypertensive_glomerular_lesion_of_hypertensive_nephropathy.jpg/296px-Histopathology_of_hypertensive_glomerular_lesion_of_hypertensive_nephropathy.jpg" decoding="async" width="198" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/63/Histopathology_of_hypertensive_glomerular_lesion_of_hypertensive_nephropathy.jpg/445px-Histopathology_of_hypertensive_glomerular_lesion_of_hypertensive_nephropathy.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/6/63/Histopathology_of_hypertensive_glomerular_lesion_of_hypertensive_nephropathy.jpg 2x" data-file-width="558" data-file-height="452" /></a></span></div> <div class="gallerytext">Light micrograph showing hypertensive glomerular lesion of hypertensive nephropathy: global glomerular collapse and filling of Bowman's space with a lightly staining collagenous material.</div> </li> <li class="gallerybox" style="width: 196px"> <div class="thumb" style="width: 194px;"><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_secondary_segmental_glomerular_sclerosis_of_hypertensive_nephropathy.jpg" class="mw-file-description" title="Light micrograph of glomerulus showing secondary segmental sclerosis of hypertensive nephropathy."><img alt="Light micrograph of glomerulus showing secondary segmental sclerosis of hypertensive nephropathy." src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Histopathology_of_secondary_segmental_glomerular_sclerosis_of_hypertensive_nephropathy.jpg/291px-Histopathology_of_secondary_segmental_glomerular_sclerosis_of_hypertensive_nephropathy.jpg" decoding="async" width="194" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Histopathology_of_secondary_segmental_glomerular_sclerosis_of_hypertensive_nephropathy.jpg/436px-Histopathology_of_secondary_segmental_glomerular_sclerosis_of_hypertensive_nephropathy.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/d/d9/Histopathology_of_secondary_segmental_glomerular_sclerosis_of_hypertensive_nephropathy.jpg 2x" data-file-width="555" data-file-height="458" /></a></span></div> <div class="gallerytext">Light micrograph of glomerulus showing secondary segmental sclerosis of hypertensive nephropathy.</div> </li> <li class="gallerybox" style="width: 297.33333333333px"> <div class="thumb" style="width: 295.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_arcuate_artery_nephrosclerosis,_annotated.jpg" class="mw-file-description" title="Histopathology of arcuate artery nephrosclerosis, seen as a thickened intima with an onion skin-like architecture. It is presumably a manifestation of hypertensive kidney disease."><img alt="Histopathology of arcuate artery nephrosclerosis, seen as a thickened intima with an onion skin-like architecture. It is presumably a manifestation of hypertensive kidney disease." src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Histopathology_of_arcuate_artery_nephrosclerosis%2C_annotated.jpg/443px-Histopathology_of_arcuate_artery_nephrosclerosis%2C_annotated.jpg" decoding="async" width="296" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Histopathology_of_arcuate_artery_nephrosclerosis%2C_annotated.jpg/665px-Histopathology_of_arcuate_artery_nephrosclerosis%2C_annotated.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Histopathology_of_arcuate_artery_nephrosclerosis%2C_annotated.jpg/886px-Histopathology_of_arcuate_artery_nephrosclerosis%2C_annotated.jpg 2x" data-file-width="1497" data-file-height="811" /></a></span></div> <div class="gallerytext">Histopathology of <a href="/wiki/Arcuate_arteries_of_the_kidney" title="Arcuate arteries of the kidney">arcuate artery</a> nephrosclerosis, seen as a thickened intima with an onion skin-like architecture. It is presumably a manifestation of hypertensive kidney disease.</div> </li> <li class="gallerybox" style="width: 252px"> <div class="thumb" style="width: 250px;"><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_renal_interstitial_fibrosis_of_hypertensive_nephropathy.jpg" class="mw-file-description" title="Light micrograph showing signs of hypertensive nephropathy: interstitial fibrosis, tubular atrophy with thickened tubular basement membranes, and fibrous intimal thickening of a small artery (arrow)."><img alt="Light micrograph showing signs of hypertensive nephropathy: interstitial fibrosis, tubular atrophy with thickened tubular basement membranes, and fibrous intimal thickening of a small artery (arrow)." src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Histopathology_of_renal_interstitial_fibrosis_of_hypertensive_nephropathy.jpg/375px-Histopathology_of_renal_interstitial_fibrosis_of_hypertensive_nephropathy.jpg" decoding="async" width="250" height="160" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Histopathology_of_renal_interstitial_fibrosis_of_hypertensive_nephropathy.jpg/562px-Histopathology_of_renal_interstitial_fibrosis_of_hypertensive_nephropathy.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/6/6f/Histopathology_of_renal_interstitial_fibrosis_of_hypertensive_nephropathy.jpg 2x" data-file-width="610" data-file-height="391" /></a></span></div> <div class="gallerytext">Light micrograph showing signs of hypertensive nephropathy: interstitial fibrosis, tubular atrophy with thickened tubular basement membranes, and fibrous intimal thickening of a small artery (arrow).</div> </li> </ul> <p>Malignant nephrosclerosis is where hypertensive nephrosclerosis occurs in presence of <a href="/wiki/Hypertensive_emergency" title="Hypertensive emergency">malignant hypertension</a> (when DBP > 130mmHg).<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Vessels feature <a href="/wiki/Tunica_intima" title="Tunica intima">intimal</a> thickening, <a href="/wiki/Fibrinoid_necrosis" title="Fibrinoid necrosis">fibrinoid necrosis</a>, <a href="/wiki/Schistocyte" title="Schistocyte">red blood cell fragmentation</a>, <a href="/wiki/Extravasation" title="Extravasation">extravasation</a>, <a href="/wiki/Thrombosis" title="Thrombosis">thrombosis</a>. These changes create an exaggerated layered appearance (onion skinning).<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Urine_test">Urine test</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=8" title="Edit section: Urine test"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Microalbuminuria" title="Microalbuminuria">Microalbuminuria</a> (moderate increase in the levels of urinary albumin) is a non-specific finding in patients with vascular disease that is associated with increased risk of cardiovascular events. The majority of patients with benign nephrosclerosis have <a href="/wiki/Proteinuria" title="Proteinuria">proteinuria</a> in the range from 0.5 to 1 g/ 24hr. In the case of glomerular damage occurring in HN, <a href="/wiki/Hematuria" title="Hematuria">hematuria</a> can occur as well.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2019)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Definitive_diagnosis">Definitive diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=9" title="Edit section: Definitive diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The definitive diagnosis of HN requires morphological examination. Common histological features can be identified in the renal and glomerular vasculature. Glomerulosclerosis is often present, either <a href="/wiki/Focal_segmental_glomerulosclerosis" title="Focal segmental glomerulosclerosis">focally</a> or globally, which is characterized by hardening of the vessel walls. Also, luminal narrowing of the arteries and arterioles of the kidney system. However, this type of procedure is likely to be preceded by a provisional diagnosis based on laboratory investigations.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Future_diagnostic_approaches">Future diagnostic approaches</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=10" title="Edit section: Future diagnostic approaches"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Increasing access to, and use of, genome profiling may provide opportunity for diagnosis based on presentation and genetic risk factors, by identifying ApoL1 gene variants on <a href="/wiki/Chromosome_22_(human)" class="mw-redirect" title="Chromosome 22 (human)">chromosome 22.</a><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=11" title="Edit section: Management"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Management_of_hypertension" title="Management of hypertension">Management of hypertension</a></div> <p>The aim of the medical treatment is to slow the progression of <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a> by reducing blood pressure and <a href="/wiki/Albumin" title="Albumin">albumin</a> levels.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The current published guidelines define ideal BP of <130/80 mmHg for patients with hypertensive nephropathy; studies show that anything higher or lower than this can increase cardiovascular risk. According to the African American Study of Kidney Disease (AASK) trial, after an additional 5 years follow-up upon completion of the 10-year trial, up to 65% of the cohort had progressive nephropathy despite having controlled the mean systolic BP level <135 mmHg.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/ACE_inhibitors" class="mw-redirect" title="ACE inhibitors">ACE inhibitors</a>, <a href="/wiki/Angiotensin_receptor_blockers" class="mw-redirect" title="Angiotensin receptor blockers">angiotensin receptor blockers</a>, direct <a href="/wiki/Renin_inhibitors" class="mw-redirect" title="Renin inhibitors">renin inhibitors</a> and <a href="/wiki/Aldosterone_antagonists" class="mw-redirect" title="Aldosterone antagonists">aldosterone antagonists</a>, are pharmacological treatments that can be used to lower BP to target levels; hence reducing neuropathy and <a href="/wiki/Proteinuria" title="Proteinuria">proteinuria</a> progression. The management plan should be individualized based on the condition of the patients including comorbidities and previous medical history.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> In addition, there are lifestyle changes that can be made. Weight reduction, exercise, reducing salt intake can be done to manage hypertensive nephropathy.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=12" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>According to the United States Renal Data System (USRDS), hypertensive nephropathy accounts for more than one-third of patients on hemodialysis and the annual mortality rate for patients on hemodialysis is 23.3%. Haemodialysis is recommended for patients who progress to end-stage kidney disease (ESKD) and hypertensive nephropathy is the second most common cause of ESKD after diabetes. Patient prognosis is dependent on numerous factors including age, ethnicity, blood pressure and glomerular filtration rate. Changes in lifestyle factors, such as reduced salt intake and increased physical activity have been shown to improve outcomes but are insufficient without pharmacological treatment.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=13" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The incidence of hypertensive nephropathy varies around the world. For instance, it accounts for as many as 25% and 17% of patients starting dialysis for end-stage kidney disease in Italy and France respectively. Contrastingly, Japan and China report only 6 and 7% respectively. Since the year 2000, nephropathy caused by hypertension has increased in incidence by 8.7% <sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> In reality, these figures may be even higher, as hypertension is not always reported as the specific cause of kidney disease.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>It has been recognized that the incidence of hypertensive nephropathy varies with ethnicity. Compared to Caucasians, African Americans in the USA are much more likely to develop hypertensive nephropathy.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Of those who do, the proportion who then go on to develop end-stage <a href="/wiki/Kidney_failure" title="Kidney failure">kidney failure</a> is 3.5 times higher than in the Caucasian population. In addition to this, African Americans tend to develop hypertensive nephropathy at a younger age than Caucasians (45 to 65, compared to >65).<sup id="cite_ref-medscape_7-2" class="reference"><a href="#cite_note-medscape-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=14" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Nephropathy" class="mw-redirect" title="Nephropathy">Nephropathy</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=15" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFFervenza2016" class="citation web cs1">Fervenza, Fernando C (2016-09-08). 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Renal Disease in Racial and Ethnic Minority Groups. 63, Supplement 83 (83): S17–S21. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1046%2Fj.1523-1755.63.s83.5.x">10.1046/j.1523-1755.63.s83.5.x</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12864869">12864869</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Kidney+International&rft.atitle=Hypertensive+risk+factors+in+kidney+disease+in+African+Americans&rft.volume=63%2C+Supplement+83&rft.issue=83&rft.pages=S17-S21&rft.date=2003-02-01&rft_id=info%3Adoi%2F10.1046%2Fj.1523-1755.63.s83.5.x&rft_id=info%3Apmid%2F12864869&rft.aulast=Fogo&rft.aufirst=Agnes+B.&rft_id=https%3A%2F%2Fdoi.org%2F10.1046%252Fj.1523-1755.63.s83.5.x&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHypertensive+kidney+disease" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=16" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTylickiRutkowski2003" class="citation journal cs1 cs1-prop-foreign-lang-source">Tylicki L, Rutkowski B (2003). "Hypertensive nephropathy: pathogenesis, diagnosis and treatment". <i>Pol. Merkur. Lekarski</i> (in Polish). <b>14</b> (80): 168–73. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12728683">12728683</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Pol.+Merkur.+Lekarski&rft.atitle=Hypertensive+nephropathy%3A+pathogenesis%2C+diagnosis+and+treatment&rft.volume=14&rft.issue=80&rft.pages=168-73&rft.date=2003&rft_id=info%3Apmid%2F12728683&rft.aulast=Tylicki&rft.aufirst=L&rft.au=Rutkowski%2C+B&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHypertensive+kidney+disease" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLuft_FC2000" class="citation journal cs1">Luft FC (October 2000). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fndt%2F15.10.1515">"Hypertensive nephrosclerosis-a cause of end-stage renal disease?"</a>. <i>Nephrol Dial Transplant</i>. <b>15</b> (10): 1515–7. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fndt%2F15.10.1515">10.1093/ndt/15.10.1515</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11007815">11007815</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nephrol+Dial+Transplant&rft.atitle=Hypertensive+nephrosclerosis-a+cause+of+end-stage+renal+disease%3F&rft.volume=15&rft.issue=10&rft.pages=1515-7&rft.date=2000-10&rft_id=info%3Adoi%2F10.1093%2Fndt%2F15.10.1515&rft_id=info%3Apmid%2F11007815&rft.au=Luft+FC&rft_id=https%3A%2F%2Fdoi.org%2F10.1093%252Fndt%252F15.10.1515&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHypertensive+kidney+disease" class="Z3988"></span></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hypertensive_kidney_disease&action=edit&section=17" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output 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dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1434446" class="extiw" title="d:Q1434446">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/I12">I12</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=403">403</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D009400">D009400</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Cardiovascular_disease_(vessels)" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output 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.navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Vascular_diseases" title="Template:Vascular diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Vascular_diseases" title="Template talk:Vascular diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Vascular_diseases" title="Special:EditPage/Template:Vascular diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Cardiovascular_disease_(vessels)" style="font-size:114%;margin:0 4em"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular disease</a> (vessels)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Artery" title="Artery">Arteries</a>, <a href="/wiki/Arteriole" title="Arteriole">arterioles</a><br /> and <a href="/wiki/Capillary" title="Capillary">capillaries</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Arteritis" title="Arteritis">Arteritis</a> <ul><li><a href="/wiki/Aortitis" title="Aortitis">Aortitis</a></li></ul></li> <li><a href="/wiki/Thromboangiitis_obliterans" title="Thromboangiitis obliterans">Buerger's disease</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Arteriosclerosis" title="Arteriosclerosis">Arteriosclerosis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atherosclerosis" title="Atherosclerosis">Atherosclerosis</a> <ul><li><a href="/wiki/Foam_cell" title="Foam cell">Foam cell</a></li> <li><a href="/wiki/Fatty_streak" title="Fatty streak">Fatty streak</a></li> <li><a href="/wiki/Atheroma" title="Atheroma">Atheroma</a></li> <li><a href="/wiki/Cholesterol" title="Cholesterol">Cholesterol</a></li> <li><a href="/wiki/Low-density_lipoprotein" title="Low-density lipoprotein">LDL</a></li> <li><a href="/wiki/Oxycholesterol" title="Oxycholesterol">Oxycholesterol</a></li> <li><a href="/wiki/Trans_fat" title="Trans fat">Trans fat</a></li></ul></li> <li><a href="/wiki/Monckeberg%27s_arteriosclerosis" title="Monckeberg's arteriosclerosis">Monckeberg's arteriosclerosis</a></li> <li><a href="/wiki/Hyaline_arteriolosclerosis" class="mw-redirect" title="Hyaline arteriolosclerosis">Hyaline arteriolosclerosis</a></li> <li><a href="/wiki/Hyperplastic_arteriolosclerosis" class="mw-redirect" title="Hyperplastic arteriolosclerosis">Hyperplastic arteriolosclerosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peripheral_artery_disease" title="Peripheral artery disease">Peripheral artery disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Stenosis" title="Stenosis">Stenosis</a> <ul><li><a href="/wiki/Carotid_artery_stenosis" title="Carotid artery stenosis">Carotid artery stenosis</a></li> <li><a href="/wiki/Renal_artery_stenosis" title="Renal artery stenosis">Renal artery stenosis</a></li></ul></li> <li><a href="/wiki/Aortoiliac_occlusive_disease" title="Aortoiliac occlusive disease">Aortoiliac occlusive disease</a></li> <li><a href="/wiki/Critical_limb_ischemia" class="mw-redirect" title="Critical limb ischemia">Critical limb ischemia</a></li> <li><a href="/wiki/Degos_disease" title="Degos disease">Degos disease</a></li> <li><a href="/wiki/Erythromelalgia" title="Erythromelalgia">Erythromelalgia</a></li> <li><a href="/wiki/Fibromuscular_dysplasia" title="Fibromuscular dysplasia">Fibromuscular dysplasia</a></li> <li><a href="/wiki/Hepatic_artery_thrombosis" title="Hepatic artery thrombosis">Hepatic artery thrombosis</a></li> <li><a href="/wiki/Intermittent_claudication" title="Intermittent claudication">Intermittent claudication</a></li> <li><a href="/wiki/Raynaud%27s_phenomenon" class="mw-redirect" title="Raynaud's phenomenon">Raynaud's phenomenon</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aneurysm" title="Aneurysm">Aneurysm</a> / <a href="/wiki/Dissection_(medical)" class="mw-redirect" title="Dissection (medical)">dissection</a> /<br /> <a href="/wiki/Pseudoaneurysm" title="Pseudoaneurysm">pseudoaneurysm</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>torso</i>: <a href="/wiki/Aortic_aneurysm" title="Aortic aneurysm">Aortic aneurysm</a> <ul><li><a href="/wiki/Abdominal_aortic_aneurysm" title="Abdominal aortic aneurysm">Abdominal aortic aneurysm</a></li> <li><a href="/wiki/Thoracic_aortic_aneurysm" title="Thoracic aortic aneurysm">Thoracic aortic aneurysm</a></li> <li><a href="/wiki/Aneurysm_of_sinus_of_Valsalva" title="Aneurysm of sinus of Valsalva">Aneurysm of sinus of Valsalva</a></li></ul></li> <li><a href="/wiki/Aortic_dissection" title="Aortic dissection">Aortic dissection</a></li> <li><a href="/wiki/Aortic_rupture" title="Aortic rupture">Aortic rupture</a></li> <li><a href="/wiki/Coronary_artery_aneurysm" title="Coronary artery aneurysm">Coronary artery aneurysm</a></li> <li><i>head / neck</i> <ul><li><a href="/wiki/Intracranial_aneurysm" title="Intracranial aneurysm">Intracranial aneurysm</a></li> <li><a href="/wiki/Intracranial_berry_aneurysm" class="mw-redirect" title="Intracranial berry aneurysm">Intracranial berry aneurysm</a></li> <li><a href="/wiki/Carotid_artery_dissection" title="Carotid artery dissection">Carotid artery dissection</a></li> <li><a href="/wiki/Vertebral_artery_dissection" title="Vertebral artery dissection">Vertebral artery dissection</a></li> <li><a href="/wiki/Familial_aortic_dissection" title="Familial aortic dissection">Familial aortic dissection</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vascular_malformation" title="Vascular malformation">Vascular malformation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Arteriovenous_fistula" title="Arteriovenous fistula">Arteriovenous fistula</a></li> <li><a href="/wiki/Arteriovenous_malformation" title="Arteriovenous malformation">Arteriovenous malformation</a></li> <li><a href="/wiki/Telangiectasia" title="Telangiectasia">Telangiectasia</a> <ul><li><a href="/wiki/Hereditary_hemorrhagic_telangiectasia" title="Hereditary hemorrhagic telangiectasia">Hereditary hemorrhagic telangiectasia</a></li> <li><a href="/wiki/Generalized_essential_telangiectasia" title="Generalized essential telangiectasia">Generalized essential telangiectasia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nevus#Vascular_nevus" title="Nevus">Vascular nevus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cherry_hemangioma" class="mw-redirect" title="Cherry hemangioma">Cherry hemangioma</a></li> <li><a href="/wiki/Halo_nevus" title="Halo nevus">Halo nevus</a></li> <li><a href="/wiki/Spider_angioma" title="Spider angioma">Spider angioma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vein" title="Vein">Veins</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Phlebitis" title="Phlebitis">Phlebitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Venous_thrombosis" title="Venous thrombosis">Venous thrombosis</a> /<br /> <a href="/wiki/Thrombophlebitis" title="Thrombophlebitis">Thrombophlebitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>primarily lower limb</i> <ul><li><a href="/wiki/Deep_vein_thrombosis" title="Deep vein thrombosis">Deep vein thrombosis</a></li></ul></li> <li><i>abdomen</i> <ul><li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li> <li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li> <li><a href="/wiki/May%E2%80%93Thurner_syndrome" title="May–Thurner syndrome">May–Thurner syndrome</a></li> <li><a href="/wiki/Portal_vein_thrombosis" title="Portal vein thrombosis">Portal vein thrombosis</a></li> <li><a href="/wiki/Renal_vein_thrombosis" title="Renal vein thrombosis">Renal vein thrombosis</a></li></ul></li> <li><i>upper limb / torso</i> <ul><li><a href="/wiki/Mondor%27s_disease" class="mw-redirect" title="Mondor's disease">Mondor's disease</a></li> <li><a href="/wiki/Paget%E2%80%93Schroetter_disease" title="Paget–Schroetter disease">Paget–Schroetter disease</a></li> <li><a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">Pulmonary embolism</a></li></ul></li> <li><i>head</i> <ul><li><a href="/wiki/Cerebral_venous_sinus_thrombosis" title="Cerebral venous sinus thrombosis">Cerebral venous sinus thrombosis</a></li></ul></li> <li><a href="/wiki/Post-thrombotic_syndrome" title="Post-thrombotic syndrome">Post-thrombotic syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Varicose_veins" title="Varicose veins">Varicose veins</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastric_varices" title="Gastric varices">Gastric varices</a></li> <li><a href="/wiki/Portacaval_anastomosis" title="Portacaval anastomosis">Portacaval anastomosis</a> <ul><li><a href="/wiki/Caput_medusae" title="Caput medusae">Caput medusae</a></li> <li><a href="/wiki/Esophageal_varices" title="Esophageal varices">Esophageal varices</a></li> <li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li></ul></li> <li><a href="/wiki/Varicocele" title="Varicocele">Varicocele</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chronic_venous_insufficiency" title="Chronic venous insufficiency">Chronic venous insufficiency</a></li> <li><a href="/wiki/Chronic_cerebrospinal_venous_insufficiency" class="mw-redirect" title="Chronic cerebrospinal venous insufficiency">Chronic cerebrospinal venous insufficiency</a></li> <li><a href="/wiki/Superior_vena_cava_syndrome" title="Superior vena cava syndrome">Superior vena cava syndrome</a></li> <li><a href="/wiki/Inferior_vena_cava_syndrome" title="Inferior vena cava syndrome">Inferior vena cava syndrome</a></li> <li><a href="/wiki/Venous_ulcer" title="Venous ulcer">Venous ulcer</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Arteries or veins</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Angiopathy" title="Angiopathy">Angiopathy</a> <ul><li><a href="/wiki/Macroangiopathy" class="mw-redirect" title="Macroangiopathy">Macroangiopathy</a></li> <li><a href="/wiki/Microangiopathy" title="Microangiopathy">Microangiopathy</a></li></ul></li> <li><a href="/wiki/Embolism" title="Embolism">Embolism</a> <ul><li><a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">Pulmonary embolism</a></li> <li><a href="/wiki/Cholesterol_embolism" title="Cholesterol embolism">Cholesterol embolism</a></li> <li><a href="/wiki/Paradoxical_embolism" title="Paradoxical embolism">Paradoxical embolism</a></li></ul></li> <li><a href="/wiki/Thrombosis" title="Thrombosis">Thrombosis</a></li> <li><a href="/wiki/Vasculitis" title="Vasculitis">Vasculitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Blood_pressure" title="Blood pressure">Blood pressure</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hypertension" title="Hypertension">Hypertension</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypertensive_heart_disease" title="Hypertensive heart disease">Hypertensive heart disease</a></li> <li><a href="/wiki/Hypertensive_emergency" title="Hypertensive emergency">Hypertensive emergency</a></li> <li><a href="/wiki/Hypertensive_nephropathy" class="mw-redirect" title="Hypertensive nephropathy">Hypertensive nephropathy</a></li> <li><a href="/wiki/Essential_hypertension" title="Essential hypertension">Essential hypertension</a></li> <li><a href="/wiki/Secondary_hypertension" title="Secondary hypertension">Secondary hypertension</a> <ul><li><a href="/wiki/Renovascular_hypertension" title="Renovascular hypertension">Renovascular hypertension</a></li></ul></li> <li><a href="/wiki/Benign_hypertension" title="Benign hypertension">Benign hypertension</a></li> <li><a href="/wiki/Pulmonary_hypertension" title="Pulmonary hypertension">Pulmonary hypertension</a></li> <li><a href="/wiki/Systolic_hypertension" title="Systolic hypertension">Systolic hypertension</a></li> <li><a href="/wiki/White_coat_hypertension" title="White coat hypertension">White coat hypertension</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hypotension" title="Hypotension">Hypotension</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Orthostatic_hypotension" title="Orthostatic hypotension">Orthostatic hypotension</a></li> <li><a href="/wiki/Shock_(circulatory)" title="Shock (circulatory)">Shock (circulatory)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Kidney_disease" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Kidney_disease" title="Template:Kidney disease"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Kidney_disease" title="Template talk:Kidney disease"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Kidney_disease" title="Special:EditPage/Template:Kidney disease"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Kidney_disease" style="font-size:114%;margin:0 4em"><a href="/wiki/Kidney_disease" title="Kidney disease">Kidney disease</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Glomerulopathy" title="Glomerulopathy">Glomerular disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>See <a href="/wiki/Template:Glomerular_disease" title="Template:Glomerular disease">Template:Glomerular disease</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Tubulopathy" title="Tubulopathy">Tubules</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Renal_tubular_acidosis" title="Renal tubular acidosis">Renal tubular acidosis</a> <ul><li><a href="/wiki/Proximal_renal_tubular_acidosis" title="Proximal renal tubular acidosis">proximal</a></li> <li><a href="/wiki/Distal_renal_tubular_acidosis" title="Distal renal tubular acidosis">distal</a></li></ul></li> <li><a href="/wiki/Acute_tubular_necrosis" title="Acute tubular necrosis">Acute tubular necrosis</a></li> <li>Genetic <ul><li><a href="/wiki/Fanconi_syndrome" title="Fanconi syndrome">Fanconi syndrome</a></li> <li><a href="/wiki/Bartter_syndrome" title="Bartter syndrome">Bartter syndrome</a></li> <li><a href="/wiki/Gitelman_syndrome" title="Gitelman syndrome">Gitelman syndrome</a></li> <li><a href="/wiki/Liddle%27s_syndrome" title="Liddle's syndrome">Liddle's syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medullary_interstitium" class="mw-redirect" title="Medullary interstitium">Interstitium</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Interstitial_nephritis" title="Interstitial nephritis">Interstitial nephritis</a> <ul><li><a href="/wiki/Pyelonephritis" title="Pyelonephritis">Pyelonephritis</a></li> <li><a href="/wiki/Balkan_endemic_nephropathy" title="Balkan endemic nephropathy">Balkan endemic nephropathy</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Renal_artery_stenosis" title="Renal artery stenosis">Renal artery stenosis</a></li> <li><a href="/wiki/Renal_ischemia" class="mw-redirect" title="Renal ischemia">Renal ischemia</a></li> <li><a href="/wiki/Hypertensive_nephropathy" class="mw-redirect" title="Hypertensive nephropathy">Hypertensive nephropathy</a></li> <li><a href="/wiki/Renovascular_hypertension" title="Renovascular hypertension">Renovascular hypertension</a></li> <li><a href="/wiki/Renal_cortical_necrosis" title="Renal cortical necrosis">Renal cortical necrosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General syndromes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Nephritis" title="Nephritis">Nephritis</a></li> <li><a href="/wiki/Nephrosis" title="Nephrosis">Nephrosis</a></li> <li><a href="/wiki/Renal_failure" class="mw-redirect" title="Renal failure">Renal failure</a> <ul><li><a href="/wiki/Acute_kidney_injury" title="Acute kidney injury">Acute renal failure</a></li> <li><a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">Chronic kidney disease</a></li> <li><a href="/wiki/Uremia" title="Uremia">Uremia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Analgesic_nephropathy" title="Analgesic nephropathy">Analgesic nephropathy</a></li> <li><a href="/wiki/Renal_osteodystrophy" title="Renal osteodystrophy">Renal osteodystrophy</a></li> <li><a href="/wiki/Nephroptosis" title="Nephroptosis">Nephroptosis</a></li> <li><a href="/wiki/Abderhalden%E2%80%93Kaufmann%E2%80%93Lignac_syndrome" class="mw-redirect" title="Abderhalden–Kaufmann–Lignac syndrome">Abderhalden–Kaufmann–Lignac syndrome</a></li> <li><a href="/wiki/Diabetes_insipidus" title="Diabetes insipidus">Diabetes insipidus</a> <ul><li><a href="/wiki/Nephrogenic_diabetes_insipidus" title="Nephrogenic diabetes insipidus">Nephrogenic</a></li></ul></li> <li><a href="/wiki/Renal_papilla" class="mw-redirect" title="Renal papilla">Renal papilla</a> <ul><li><a href="/wiki/Renal_papillary_necrosis" title="Renal papillary necrosis">Renal papillary necrosis</a></li></ul></li> <li><a href="/wiki/Major_calyx" class="mw-redirect" title="Major calyx">Major calyx</a>/<a href="/wiki/Renal_pelvis" title="Renal pelvis">pelvis</a> <ul><li><a href="/wiki/Hydronephrosis" title="Hydronephrosis">Hydronephrosis</a></li> <li><a href="/wiki/Pyonephrosis" title="Pyonephrosis">Pyonephrosis</a></li> <li><a href="/wiki/Reflux_nephropathy" title="Reflux nephropathy">Reflux nephropathy</a></li></ul></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img 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