Nephrosclerosis is a condition in which the renal arterioles and small arteries (hardened) over time. This disease also has many common underlying causes, with hypertension being the primary one. Nevertheless, other co-factors, such as diabetes and chronic kidney disease, cannot be ruled out in some cases. 

Nephrosclerosis implies the gradual hardening of blood vessels in the kidney. The disease may be chronic and worsen over time, and if there is no treatment, kidneys can fail. 

Tendencies of the nephrosclerosis to develop without apparent symptoms are very common in its early stages. In the beginning, the symptoms may be as mild as proteinuria, hematuria and hypertension which is hard to control, and results in fluid retention and declining renal function. 

Age: With age, risk for nephrosclerosis also rises, further reinforcing the gradual onset surrounding renal diseases. During the aging process blood vessels grow stiffer and have tendency to form high blood pressure which may lead to nephrosclerosis. 
Race: Unlike some other diseases that are experienced by all people irrespective of descent, some are more likely to affect a particular group. As hypertension, diabetes and renal diseases compared to other ethnicities are more prevalent in African Americans explaining this fact by higher incidence of this disease in this particular group of people. 
Other Risk Factors: Hypertension developed from smoking, obesity or high cholesterol and other factors that promote nephrosclerosis is determined by family history of kidney disease. 
Chronic Kidney Disease (CKD): Although the elderly are more often, than not affected by CKD, nephrosclerosis is also one of its contributors.  

The leading factor in nephrosclerosis is probably high blood pressure. Pathologic occurrence of stenosis of the arteries initiated by elevated blood pressure and high cholesterol also triggers narrowing of the veins and impairs venous endothelial structure. The amount of smooth muscle cells, which have the size of the mass also increase in similar manner, therefore resulting in additionally beefing up the walls of the arteries. Fibrosis following occurs so that hardening of artery walls and reducing elasticity their occur, which further cause difficulties in blood flow to the kidneys. There will be an insufficient blood flow which in turn will activate the renin-angiotensin-aldosterone system. In the long run, the system ends up ultimately causing vasoconstriction and sodium retention which increases blood pressure and further damages to the blood vessels. 

Diabetes: Those people who have diabetes mellitus are more susceptible for nephrosclerosis.  
Aging: Vascular change-related with aging could also contribute the development of nephrosclerosis. 
Atherosclerosis: Atherosclerosis are frequently accompanied with plaque accumulation, the condition of hardening and narrowing of the arteries might influence the vessels of kidneys alike. Atherosclerosis and the related kidney arteries narrowing occur and develop nephrosclerosis.  
Smoking: Tobacco smoking brings in the distinct risk of inducing nephrosclerosis. 
Obesity: Nephrosclerosis may involve obesity and increased body mass as one of its causative components.

Some genes, for example the inheritance of chronic renal disease or high blood pressure, are critical risk factors. 

• Hypertension causes nephrosclerosis risk increase. 
• Hypertension and diabetes as an individual disease increases the risk of developing nephrosclerosis. 
• Nephrosclerosis becomes more a risk when age increases. 
• Proteinuria is a warning sign of the advanced stage of kidney lesions in the nephrosclerosis. 

Age group 
Nephrosclerosis mostly affects the adults especially those over the age of 60. This can also occur in different age groups also. 

Blood Pressure 

Fluid Status 

Heart Sounds 

Abdominal Examination 

Neurological Examination 

Fundoscopic Examination 

Skin Examination 

Urinalysis 

Hypertension  

Diabetes 

Atherosclerosis 

Obesity 

Smoking 

Genetic Factors 

Chronic NSAID Use 

Asymptomatic Stage: Initially the nephrosclerosis may be not accompanied by any alarming signs.   
Hypertension: Hypertension happens to be the events that bring about the development of nephrosclerosis and it is also a very common symptom of the disorder. The ability to balance medication with other means can be difficult. 
Decreased Urine Output: Renal artery disease may lead the stage of nephrosclerosis where the production of urine is reduced because of the kidney impairment. Thus the patient may experience symptoms like oliguria. 
Proteinuria: In this disorder protein contains (proteinuria) in the urine because of kidney damage. This takes place when these filters glomeruli of the kidneys are damaged. 
Edema: The swelling of the lower extremities particularly might be caused by a retention of fluid because of the damage to kidneys by the disease. 

Blood Pressure Control: Nephrosclerosis is best combatted through blood pressure control, which involves a lifestyle practices and drugs like ACE inhibitors and diuretics. 
Diabetes Management: Blood sugar control is a key part of diabetes management to protect kidney function requires taking medicine, making diet changes and self-monitoring glucose level. 
Lifestyle Modifications: Healthy practices such as maintaining appropriate weight and staying away from smoking and managing stress can delay the development of nephrosclerosis. 
Medications for Kidney Protection: Statins will be administered to control both high blood pressure and uncontrolled diabetes. These medications will also ensure the safety of the kidneys. 
Dialysis or Transplant: Nephrosclerosis progression to end-stage may require dialysis to filter blood or kidney transplant to take over the failed kidney. 

Nephrology

Diabetes Control: Carefully control diet according to the diabetic patient requirement and also make some lifestyle changes for healthy living. 
Hydration: Drink plenty of water to provide toxin-flushing mechanism but consume a certain volume customized for your health condition and medical advice. 
Regular Exercise: Attend exercise sessions to keep your blood pressure down, blood sugar under control and your weight within normal limits and improve your cardiovascular health. Decide for yourself which safe activities suit your level and fitness conditions rather than forcing yourself to do something that may put your health at risk. 
Smoking Cessation: Stop smoking to avoid kidney problems and you can do it by preventing worsening of hypertension and cardiovascular health issues. 
Stress Management: A stress management technique that can be yoga, mindfulness and  meditation or therapy to maintain blood pressure and the general state of well-being. 

Nephrology

Hydrochlorthiazide 

By promoting the excretion of sodium and water, it reduces the volume of blood circulating through the blood vessels, thus decreasing blood pressure. In nephrosclerosis. 

Nephrology

Fosinopril 

The drug blocks the formation of angiotensin II, and so dilate the blood vessels, lower blood pressure and promote better blood flow to the kidneys.

Ramipril 

Through this process, ramipril which is a suppressant of the conversion of angiotensin I-angiotensin II, leads to vasodilation and thus reduced peripheral vasoconstriction hence reduced mean arterial blood pressure. 

Nephrology

Aliskiren 

Aliskiren blocks the activity of renin, the enzyme responsible for converting angiotensinogen into angiotensin I. By inhibiting renin, aliskiren reduces the production of angiotensin I. 

Nephrology

Amlodipine 
Amlodipine mainly targets calcium channels in the muscular cells that surrounds the blood vessels through blocking the channel flow, causing their cells to loosen up and dilate that subsequently decreasing blood pressure. 
Felodipine 
It facilitates the smooth muscle relaxation of the coronary arteries hence, leads to vasodilatation.  

Nephrology

Labetalol 

Labetalol blocks beta-adrenergic receptors in the body. 

It helps in reducing hypertension. 

Nephrology

Minoxidil  

The strongest oral vasodilator. It relaxes arteriolar smooth muscle, leading to reduced blood pressure. 

Hydralazine 

It works by reducing systemic resistance by directly widening the arterioles. 

Nephrology

Doxazosin 

By blocking alpha receptors, doxazosin causes blood vessels to dilate (widen), resulting in decreased resistance to blood flow and lower blood pressure. 

Nephrology

Nephrectomy: When a person becomes acute for this disorder, they suffer from certain complications like uncontrolled blood pressure or infection. In that case, a nephrectomy is a surgical option for removing the affected kidney. 

 Kidney transplant: This may be the choice of people who are in the final stages of kidney disease caused by nephrosclerosis. During a kidney transplant, the donor’s healthy kidney is placed in the patient instead of his/her kidneys. This type of transplant is usually considered to achieve the desired result. 

Nephrology

Early detection is the key to managing nephrosclerosis and to identify the diagnosis, blood pressure measurement, urine tests and imaging studies are used. 

Lifestyle changes and medications to improve blood pressure are essential in regulating blood circulation. 

Frequent blood pressure checks, kidney function monitoring and follow-up consultations are necessary for efficiently managing nephrosclerosis.