Tuesday, June 18, 2013

Chronic Parenchymal Renal Disease

The definition of renal parenchyma 
According to the anatomical structure, kidney can be divided into renal parenchyma and renal interstitiumRenal parenchyma is comprised of functional unit (or nephron) and collecting duct. Renal interstitium is comprised of interstitial cell and loose extracellular matrix. Nephron is the essential structure and functional unit of the kidney and each human kidney contains about more than one million nephrons. The essential components of the nephron include the renal or malpighian corpuscle (glomerulus and Bowman capsule) and all segments of the renal tubule, including: proximal tubule, the medullary ascending and descending limbs, the distal tubule, but the collecting duct is excluded.  
 Features of the vessels: Compared with the efferent arteriole, the afferent arteriole is thick and straight, and the efferent arteriole is thin and long, which forms certain capillary lumen pressure difference between the two, thus that hydrostatic pressure of the glomerular capillary is higher than that of other parts in our body, so it is good for the filtration function of the glomerular capillary (Filtration function of the glomerulus).   
Clinical manifestation 
1. high blood pressure 
High blood pressure caused by renal parenchymal lesion accounts for 5% to 10% of all high blood pressure, which also ranks first among secondary high blood pressure. The prognosis of high blood pressure caused by renal parenchymal lesion is bad, which is also the most dangerous factor which can worsen the chronic kidney failure. 
2. Most patients with chronic parenchymal renal lesion have anemia, which is caused by not one factor. For example, there are many toxins in the blood, which will shorten the lifespan of red blood cell, thus causing anemia. 
3. The lesion in eye ground is more serious, and patients are also likely to have complication such as disease in heart and blood vessels. 
4. Compared with primary high blood pressure, high blood pressure caused by renal parenchyma disease are much easier to develop into progressive high blood pressure or malignant high blood pressure. Its morbidity is also twice higher than that of primary one. The prognosis is also not as good as the primary one. 
5. Patients with chronic parenchymal renal disease have abnormal urine test report such as protein in urine, creatinine level and so on. 

4 comments:

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