Symptoms include restlessness, confusion, sleepiness, blurred vision, headache, nausea, and vomiting. By viewing the back of the eye with an ophthalmoscope, a doctor can see areas of bleeding, collections of fluid, and swelling of the optic nerve. The heart becomes enlarged, and heart failure is common. Because the kidneys malfunction, protein can pass into the urine. Blood cells, detected by microscopic examination, appear in the urine, and casts of clumped red blood cells also may be seen.
Anemia often results from the breakdown and impaired production of red blood cells.
Widespread clotting within the blood vessels is also common. If the condition is not treated, about 50 percent of the people who have it die within 6 months, and most of the remainder die within a year. Lowering the blood pressure and treating the kidney failure significantly reduce the death rate, especially from heart and kidney failure and strokes. People who have less severe kidney failure improve the most with treatment. For most people, the extraordinarily high blood pressure can be lowered satisfactorily with diet and drug therapy.