Renal Hypertension in Physiology

1. RENAL HYPERTENSION
MARYAM JAMILAH BINTI ABDUL HAMID
082013100002
IMS BANGALORE

2. LEARNING OUTCOME
• What is renal hypertension?
• How does renal disease cause hypertension?
–mechanisms
• Investigations, clinical features and
treatments/managements

3. DEFINITION
“High blood pressure resulting from
kidney disease”

4. ETIOLOGY
RENAL STENOSIS
 Decrease in the diameter
of the renal arteries
 Atherosclerosis; fat,
cholesterol, calcium and
other material found in
the blood
 Fibromuscular dysplasia;
abnormal development
or growth of cells on the
renal artery walls
Fibromuscular
dysplasia
Plaques

5. CHRONIC GLOMERULONEPHRITIS
Inflammation of the
glomerular
Caused by:
 Strep throat
 Systemic Lupus
Erythematosus (SLE)
 Goodpasture’s
syndrome
 Amyloidosis
 Wegener’s
granulomatosis
 Polyarteritis nodosa

6. PATHOPHYSIOLOGY
2 ways:
1. Increased renal vascular resistance
2. Decreased glomerular capillary function
coefficient

7. 1)Increased renal vascular resistance
Renal stenosis
pressure at
afferent arteriole
in the kidney
blood flow to
the kidney
renal perfusion
glomerular
filtrate rate (GFR)
Stimulates renin
release by kidney
Renin activates
renin-angiotensin
system
Angiotensinogen
to Angiotensin I
Angiotensin I to
Angiotensin II

9. 2)Decreased glomerular capillary function
coefficient
Chronic glomerulonephritis

10. Inflammation and thickening of the glomerular capillary membranes
Chronic glomerulonephritis
Larger slit in between podocytes
Reduce the glomerular capillary filtration coefficient
Proteinuria

11. INVESTIGATIONS
Renal stenosis
• Blood tests
• Urine tests
• Kidney ultrasound

12. Glomerulonephritis
• Kidney biopsy
• Abdominal CT Scan
• Kidney ultrasound
• Urinalysis
• Blood tests

13. CLINICAL FEATURES
RENAL STENOSIS
• High blood pressure
– Hard to control

14. GLOMERULONEPHRITIS
• High blood pressure
• Haemouria and proteinuria
• Edema in ankles and face
• Bubbly or foamy urine (from excess protein)

15. TREATMENTS
RENAL STENOSIS
• Angioplasty with or without stenting
• Statin drugs (reduce the lipid)
• Revascularization

16. GLOMERULONEPHRITIS
• Eat less protein, salt and potassium
• Control your blood pressure
• Take diuretics (water pills) to treat puffiness
and swelling

17. REFERENCES
• GUYTON & HALL
• https://www.kidney.org/atoz/content/glomer
ul.cfm
• http://www.medicinenet.com/renal_artery_st
enosis/article.htm

18. THANK YOU