HTN, Diabetes, and the Kidney
Hypertensive Nephropathy
HTN causes progressive hyaline arteriosclerosis in renal arteries → Chronic and progressive renal ischaemia → Tubular atrophy, interstitial fibrosis, and glomerular sclerosis → CKD
USS will show small, fibrotic kidneys.
Diabetic Nephropathy
This starts with microalbuminuria, which indicated by a raised ACR - > 2.5 in men or > 3.5 in women. All pts showing this should be started on an ACEi.
It ends with Proteinuria as a sign of kidney failure.
Important Links:
https://bestpractice.bmj.com/topics/en-gb/530 “Light micrograph showing signs of hypertensive nephropathy: interstitial fibrosis, tubular atrophy with thickened tubular basement membranes, and fibrous intimal thickening of a small artery.” © Rishi Sharma, Surineni Kamalakar, Ellen McCarthy, Timothy A. Fields, Kamal Gupta, Rajat Barua, Virginia Savin (Licensed under CC-BY 4.0) https://creativecommons.org/licenses/by/4.0/
“Histopathological image of diabetic glomerulosclerosis with nephrotic syndrome. PAS stain.” © KGH (Licensed under CC-BY 3.0) https://creativecommons.org/licenses/by/3.0/