Proteinuria in patients with arterial/arteriolar nephrosclerosis.

ABSTRACT

UNLABELLED Controversy exists regarding the level of proteinuria in patients with nephrosclerosis. MATERIAL AND METHODS: We retrospectively examined the clinical parameters of 67 patients with the histologic diagnosis of nephrosclerosis defined as arteriolar hyalinization and/or arterial intimal fibrosis in the absence of other findings in an adequate renal biopsy. Biopsies were performed for clinical indications and were submitted to Cedars-Sinai Pathology Department from January 1994 to March 1999. RESULTS: The mean age and blood pressure (+/- SD) was 60 +/- 17 years, and 139 +/- 19/80 +/- 12 mmHg. Mean serum creatinine was 2.3 +/- 1.3 mg/dl and 24-hour urinary protein excretion was 0.94 +/- 0.73 g, 66% had < or = 1 g/day, 25% had > 1 but < or = 2 g/day, 6% had > 2 g but < 3 g/day and 1 patient had nephrotic range proteinuria. Twelve patients had no history of hypertension. They had a mean blood pressure of 121 +/- 8/76 +/- 8. Their mean serum creatinine was 1.5 +/- 0.6 mg/dl and their mean 24-hour urinary protein excretion was 0.78 +/- 0.43 g. CONCLUSIONS: Our data do not confirm that of Innes et al. [1993] who reported proteinuria > 1.5 g/day in 40% and nephrotic syndrome in 22% of patients with nephrosclerosis; systemic hypertension may not be a prerequisite for the development of nephrosclerosis.