Hypertensive nephrosclerosis as a relevant cause of chronic renal failure
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Data
2001-08
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Resumo
It is currently unclear whether hypertensive nephrosclerosis (HN), usually diagnosed solely on clinical grounds,
is a relevant cause of end-stage renal disease. We biopsied 81 hypertensive outpatients (blood pressure $160/
95 mm Hg) with moderate renal insufficiency, who were referred to our service from 1988 to 1998. Patients with known
causes of hypertension, systemic disorders, rheumatic disease, or nephrotic syndrome were excluded. In 65% of patients,
HN was the sole histological abnormality associated with renal dysfunction. Benign nephrosclerosis (BN), defined as
isolated arteriolar hyalinosis and/or intimal fibrosis, was found in 18 HN patients (22%), whereas malignant
nephrosclerosis (MN), denoted mainly by myointimal cell proliferation, appeared in 35 HN patients (43%). Previously
undiagnosed primary nephritis (PN) was found in 13 patients (16%), whereas focal and segmental glomerulosclerosis,
which might be either primary or secondary to hypertension, appeared in 15 patients (19%). These findings suggest that
HN, in both its BN and MN forms, can be a definite cause of chronic renal insufficiency and that a substantial fraction
of patients with renal insufficiency and clinical diagnosis of HN may actually have PN.
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Palavras-chave
Nephrosclerosis, Hypertension, Essential, Kidney, Renal disease
Citação
CAETANO, Edna Regina Silva Pereira; ZATZ, Roberto; SALDANHA, Luís Balthazar; PRAXEDES, José Nery. Hypertensive nephrosclerosis as a relevant cause of chronic renal failure. Hypertension, Dallas, v. 38, n. 2, p. 171-176, Aug. 2001.