Nephrosclerosis: Causes, Symptoms, Treatment and Cost

Nephrosclerosis is a type of chronic kidney disease (CKD) which refers to the hardening of the small arteries in the kidneys. This condition can lead to decreased kidney function and eventual kidney failure.

There are several types of nephrosclerosis that can affect a person’s kidneys:

• Hypertensive nephrosclerosis: This type of nephrosclerosis occurs when there is a long-term, uncontrolled high blood pressure (hypertension). The high blood pressure causes damage to the small arteries in the kidneys, leading to their hardening and decreased ability to filter waste from the bloodstream.
• Diabetic nephrosclerosis: This occurs when diabetes is poorly managed, leading to damage in the tiny blood vessels in the kidneys and impairing their ability to filter out waste from the body.
• Atheroembolic renal disease (AERD): AERD occurs when fats, proteins, and other substances form clumps inside artery walls throughout your body, including those leading to your kidneys, causing them to harden and reduce their ability to filter waste products from your bloodstream.
• Focal segmental glomerulosclerosis (FSGS): FSGS affects only part of each kidney’s filtering unit (glomerulus) causing it to become scarred over time and impair its ability filter waste from your body correctly.
• Chronic pyelonephritis: This type of long-term infection can cause inflammation in one or both kidneys, gradually damaging them over time by hardening their small arteries so that they cannot effectively filter out waste materials from your body properly.

Common causes of nephrosclerosis include uncontrolled high blood pressure, uncontrolled diabetes, chronic glomerulonephritis (an inflammation of the kidneys), and recurrent urinary tract infections.

Other risk factors include smoking, obesity, heart disease, family history of kidney disease, and long-term use of certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs).

The most common symptoms of nephrosclerosis include:

• Unhealthy levels of blood pressure
• Swelling in the feet, ankles, or legs.
• Fluid retention
• Changes in urine output and colour.
• Fatigue and weakness
• Decreased appetite
• Generalised itching of the skin.
• Nausea and vomiting.

• The management of established risk factors, such as high blood pressure, diabetes, and cardiovascular disease, is an important part of nephrosclerosis prevention.
• Other lifestyle modifications include avoiding tobacco use, limiting alcohol consumption, exercising regularly, maintaining a healthy diet and weight, and controlling cholesterol levels.
• It is also important to attend regular check-ups with your doctor to monitor kidney health and receive treatment for any underlying conditions as soon as possible.

If you are suspected of having nephrosclerosis or any related kidney condition, your doctor will likely order various diagnostic tests in order to obtain an accurate diagnosis. These tests may include:

• Kidney Function Tests: This test checks for levels of creatinine and urea in the blood, which indicate how well the kidneys are functioning. Abnormal levels can suggest nephrosclerosis or other kidney problems.
• Urinalysis: This test measures the levels of various components in urine, such as proteins and electrolytes, which can help to diagnose kidney disease. It can also detect any infection present in the urinary tract that could be contributing to kidney damage.
• CT scans: Nephrosclerosis is something that may be diagnosed with the use of CT scans.These scans can help identify areas of scarring and damage to the kidneys caused by this condition. They may also reveal any blockages in the blood vessels that are supplying the kidneys with blood.
• MRI scans: An MRI scan will show changes in the structure and function of the kidneys, such as scarring and calcification. The scan can also show signs of blockage in the renal arteries or veins that could be contributing to kidney damage.
• Renal Biopsy: A renal biopsy involves taking a small sample of tissue from your kidneys in order to study it under a microscope for further diagnostic information about your condition.
• Other Clinical Tests: Your doctor may also perform other clinical tests during diagnosis including physical exams, abdominal ultrasounds, cardiac stress testing with echocardiography or nuclear imaging studies to determine if there are any underlying heart problems causing the high blood pressure associated with nephrosclerosis.

• Possible complications of nephrosclerosis include hypertension, anaemia, proteinuria, and renal failure.
• The chance of having a stroke, a heart attack, and other cardiovascular disorders can be increased by having hypertension.
• Anaemia can cause fatigue, weakness and increased risk of infection.
• Proteinuria can lead to loss of muscle mass and fluid retention.
• Renal failure can lead to electrolyte imbalances, acid-base disturbances, fluid overload and end-stage renal disease requiring dialysis or transplantation.

• Regularly practice yoga and other forms of exercise to improve blood circulation in the body and reduce stress levels.
• Herbal teas such as ashwagandha and licorice can help reduce inflammation in the kidneys caused by nephrosclerosis.
• Include Ayurvedic herbs such as Gokshura (Tribulus Terrestris), Punarnava (Boerhavia Diffusa), Varun (Crataeva nurvala), Kaasni (Cichorium intybus) in your diet to treat nephrosclerosis effectively.
• Include natural diuretics like coriander seeds, fennel seeds, and dandelion root tea in your daily routine to improve kidney function and reduce swelling caused by nephrosclerosis.

Patients with Nephrosclerosis should focus on eating a balanced diet, with an emphasis on eating plenty of fruits and vegetables, whole grains, lean proteins, and healthy fats.Drinking plenty of water is also important for those with Nephrosclerosis.

• It is generally recommended that people with nephrosclerosis limit their intake of salt, saturated fat, and processed foods.
• They should also avoid eating too much sugar and red meat.
• Foods that are high in potassium, such as bananas, oranges, and potatoes should also be avoided.
• Additionally, it is important to limit alcohol consumption and caffeine intake.

Treatment and surgeries for nephrosclerosis range from lifestyle changes to medications and dialysis.

• Lifestyle Changes: These include weight loss, reduced salt intake, exercise, and avoidance of smoking and alcohol use. These changes can help reduce the risk of complications from nephrosclerosis and improve overall health outcomes.
• Medications: Medications may be prescribed to help control symptoms of nephrosclerosis such as high blood pressure or diabetes, as well as to reduce inflammation in the kidneys or reduce fluid retention that can cause further damage to the kidneys.
• Dialysis: For those with severe cases of nephrosclerosis who have developed end-stage renal disease (ESRD), dialysis may be needed to filter waste products from the body when the kidneys are unable to do so any longer on their own. Dialysis involves running a person’s blood through an artificial machine that filters out waste products before returning it back into their bloodstream again.
• Kidney Transplant: In some cases, a transplant may be necessary if ESRD has occurred due to end-stage kidney disease caused by nephrosclerosis or if other treatments have not been successful at managing symptoms or controlling complications caused by the condition itself.

A nephrologist (a doctor who specializes in kidney diseases) can provide diagnosis and treatment for Nephrosclerosis.

The best medicines for Nephrosclerosis depend on the underlying cause and severity of the condition.

Generally, medications used to treat Nephrosclerosis include:

• Angiotensin converting enzyme (ACE) inhibitors: ACE inhibitors are commonly prescribed to treat nephrosclerosis. These medications work by preventing the production of angiotensin II, which is a hormone that can cause narrowing of the blood vessels and increase blood pressure. By blocking the production of angiotensin II, ACE inhibitors help to reduce blood pressure and improve kidney function by increasing the amount of urine produced and decreasing fluid retention in the body.
• Angiotensin II receptor blockers (ARBs): Angiotensin II receptor blockers (ARBs) are a type of medication used to treat nephrosclerosis. ARBs work by blocking the action of angiotensin II. Commonly prescribed ARBs for nephrosclerosis include Losartan, Candesartan, Valsartan, and Olmesartan.
• Diuretics: The most commonly prescribed diuretics for nephrosclerosis are thiazide diuretics, such as hydrochlorothiazide and indapamide. These agents work to reduce the absorption of sodium and chloride in the kidneys, which helps to reduce fluid retention and pressure on the vascular walls.
• Calcium channel blockers: Calcium channel blockers are often used to help decrease blood pressure and reduce the risk of kidney damage from nephrosclerosis. These medications work by blocking calcium from entering cells, allowing vessels to relax and widen, decreasing blood pressure.

• Recovery from nephrosclerosis depends on several factors such as age, overall health, and the severity of the condition.
• Generally, it can take up to two years for full recovery if treatment is started early.

• The results of treatment for nephrosclerosis depend on the severity of the condition and the type of treatment.
• In some cases, people may experience a permanent reduction in symptoms after treatment. In other cases, the symptoms may return over time and require additional treatments or lifestyle adjustments to manage them.
• It is important to follow up with a doctor regularly to ensure that any changes in symptoms are noted and addressed as needed.

Post-surgical guidelines for treating nephrosclerosis include:

• Maintaining a healthy diet and lifestyle with an emphasis on low sodium intake.
• Monitoring blood pressure and other vital signs regularly to prevent further complications.
• Taking medications such as ACE inhibitors or ARBs to control high blood pressure, reduce inflammation, and protect the kidneys from further damage.
• Regular monitoring of kidney function through urine tests or blood tests to detect any changes in kidney function due to nephrosclerosis or other diseases that may be present.
• Following up with your doctor regularly for checkups and testing as recommended by them.
• Avoiding activities that could strain the kidneys, such as strenuous exercise, heavy lifting, and dehydration from not drinking enough water or electrolytes during physical activity.
• Refraining from taking any over-the-counter medications without consulting your healthcare provider first.

• The cost of treatments for Nephrosclerosis in India can vary significantly depending on the severity and complexity of the case.
• Generally, treatments such as medications, dialysis and kidney transplantation can range anywhere from Rs. 10,000 to Rs. 15 Lakhs or more. Other associated costs like hospital stays, laboratory tests and follow up visits can add up to the overall cost of treatment.
• It is important to note that insurance coverage is usually limited for this condition so patients may have to bear a significant part of the treatment cost out of pocket.

The most common side effects of Nephrosclerosis treatments include fatigue, headaches, dizziness, nausea and vomiting, abdominal pain, diarrhea or constipation, muscle cramps, joint pain and swelling, rash or hives.

If you are suffering from any complications relating to Nephrosclerosis then you should consult a doctor nearby as they can cause complications like anemia, proteinuria, renal failure, etc. in which treatment course can range from a few months to years depending on the severity of the situation.