"Benign" hypertensive nephrosclerosis.
QJM
; 100(2): 113-9, 2007 Feb.
Article
em En
| MEDLINE
| ID: mdl-17244670
ABSTRACT
BACKGROUND:
Whether benign hypertensive nephrosclerosis (BHN) causes end-stage renal failure (ESRF) is controversial. One reason for this is the lack of biopsy evidence confirming the clinical diagnosis in most cases.AIM:
To investigate whether biopsy-proven BHN leads to ESRF.DESIGN:
Retrospective analysis.METHODS:
We analysed all cases of biopsy-proven BHN from a single centre over a period of 20 years (n = 60), followed-up for a mean +/- SD 6.7 +/- 5.5 years.RESULTS:
Patients were divided into those with stable renal function (n = 17) and those with declining function (n = 43). Mean eGFR at the time of biopsy was lower in the declining function group (29 +/- 3 vs. 44 +/- 4 ml/min/1.73 m(2), serum creatinine 280 +/- 165 vs. 161 +/- 89 mumol/l, p < 0.001), of whom 72% progressed to ESRF. Median renal survival for the whole group was 6.8 years, with 5- and 10-year survivals of 56% and 35%, respectively. Renal survival was significantly affected by initial serum creatinine, and mean systolic and diastolic blood pressures during follow-up period. Mean protein excretion was higher in the declining group, but not significantly so. On multivariate analysis, only diastolic blood pressure during follow-up predicted renal survival (p = 0.017). Median patient survival for the whole group was 9.95 years post renal biopsy, with 5- and 10-year survivals of 70% and 49% respectively. Survival was affected by initial serum creatinine, initial serum albumin and mean systolic blood pressure during follow-up. On multivariate analysis, only initial serum creatinine was significantly correlated with survival (p = 0.017).DISCUSSION:
Biopsy-proven BHN led to ESRF in a high percentage of our patients, and was associated with significant mortality.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
6_arterial_hypertension
/
6_cardiovascular_diseases
/
6_chronic_kidney_disease
Assunto principal:
Hipertensão Renal
/
Falência Renal Crônica
/
Nefroesclerose
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
QJM
Assunto da revista:
MEDICINA
Ano de publicação:
2007
Tipo de documento:
Article