Nephrosclerosis is hardening, or sclerosis, of the arteries
of thekidney due to prolonged hypertension. This causes decreased blood flow to
the kidney and patchy necrosis of the renal paren-chyma. Eventually, fibrosis
occurs and glomeruli are destroyed. Nephrosclerosis is a major cause of ESRD
(Segura, Campo, Rodicio & Ruilope, 2001).
are two forms of nephrosclerosis: malignant (accelerated) and benign. Malignant
nephrosclerosis is often associated with malignant hypertension (diastolic
blood pressure higher than 130 mm Hg). It usually occurs in young adults, and
men are af-fected twice as often as women. The disease process progresses
rapidly. Without dialysis, more than half of patients die from ure-mia in a few
years. Benign nephrosclerosis is usually found in older adults and is often
associated with atherosclerosis and hypertension.
are rare early in the disease, even though the urine usually contains protein
and occasional casts. Renal insufficiency and associated signs and symptoms
occur late in the disease.
of nephrosclerosis is aggressive antihypertensive ther-apy. In hypertensive
nephrosclerosis, therapy containing an ACE inhibitor, alone or in combination
with other antihypertensive medications, significantly reduces the incidence of
renal events. This effect is independent of blood pressure control (Segura et