Malignant hypertension (arteriolar nephrosclerosis)

Disease	Injury	Nutrition	Poison

Special Topic	Surgery	Symptoms	Test

Hypertensive kidney

Overview

Symptoms

Treatment

Prevention

Malignant hypertension (arteriolar nephrosclerosis)

Alternative Names:

Accelerated hypertension; Arteriolar nephrosclerosis; Nephrosclerosis - arteriolar; Hypertension - malignant

Symptoms:

blurred vision
headache
change in mental status
- restlessness
- anxiety
- decreased alertness, decreased ability to concentrate
- fatigue
- sleepy, stuporous, lethargic
- confused, delirious
chest pain
- mid chest location most common
- crushing or pressure sensation
shortness of breath
cough
decreased urinary output
nausea, vomiting
seizure
weakness of the arms, legs, face, or other areas
abnormal sensation (numbness) of the arms, legs, face, or other areas

Signs and tests:

Blood pressure may be extremely high. An eye examination will reveal changes that indicate high blood pressure, including papilledema (swelling of the optic nerve), retinal bleeding, or infarction (cotton wool spots or soft exudate -- fluid with cellular debris) in the retina. If not already present, acute renal failure may develop as a complication of malignant hypertension. Other complications may also develop.

Damage to the kidneys may be demonstrated by:

a BUN increase
a creatinine increase
arterial blood gas analysis shows metabolic acidosis
urinalysis shows high protein levels (especially with kidney impairment) or microscopic hematuria (blood in the urine)

A chest X-ray may indicate pulmonary (lung) congestion from fluid forced into the lungs by heart failure as a consequence of the high blood pressure.

This disease may also alter the results of the following tests:

Review Date: 12/2/2001
Reviewed By: Andrew Koren, M.D., Department of Nephrology, NYU-Mount Sinai Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.

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