Folgeerkrankung bei Hypertonie: Nierenschäden

Sequela of hypertension: kidney disease

Zusammenfassung

Zu den häufigen Folgeerkrankungen der Hypertonie gehören Nierenschäden. In den Nieren bewirkt die arterielle Hypertonie sowohl arterielle als auch kapilläre Veränderungen sowie die Entwicklung einer interstitiellen Fibrose. Die systemische oder intraglomeruläre Druckerhöhung führt zu Albuminurie und Proteinurie, die wiederum zur weiteren Schädigung der Nieren beitragen. Letztlich kann die hypertensiv bedingte Nierenschädigung zur dialysepflichtigen terminalen Niereninsuffizienz führen. Metabolische Faktoren wie eine Hyperlipidämie, Hyperurikämie, Hyperhomozysteinämie und Insulinresistenz können die renalen Läsionen potenzieren. Eine konsequente Blutdrucksenkung zusammen mit einer Behandlung der metabolischen Risikofaktoren ist daher von entscheidender Bedeutung, um eine chronische Nierenschädigung, die wiederum als Faktor der Hypertonieverschlechterung angesehen werden muss, zu verhindern.

Abstract

Nephropathy is one of the frequent sequelae of hypertension. Arterial hypertension causes both arterial and capillary changes in the kidneys as well as development of interstitial fibrosis. Systemic or intraglomerular pressure increase leads to albuminuria and proteinuria, which in turn contributes to further damage of the kidneys. Impairment of the kidneys due to hypertension can ultimately result in terminal renal insufficiency necessitating dialysis. Metabolic factors such as hyperlipidemia, hyperuricemia, hyperhomocysteinemia, and insulin resistance can aggravate renal lesions. Effective lowering of blood pressure in conjunction with management of the metabolic risk factors is decisive for prevention of chronic kidney disease, which in turn must be considered a factor involved in exacerbation of the hypertension.

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Correspondence to W. H. Hörl FRCP.

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Hörl, W.H. Folgeerkrankung bei Hypertonie: Nierenschäden. Internist 47, 226–232 (2006). https://doi.org/10.1007/s00108-005-1575-6

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Schlüsselwörter

  • Hypertensive Nephropathie
  • Hypertonie
  • Nierenschäden
  • Nephroangiosklerose

Keywords

  • Hypertensive nephropathy
  • Hypertension
  • Kidney damage
  • Nephroangiosclerosis