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2016 ; 17
(ä): 42
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Clinico-pathological characteristics and outcomes of patients with biopsy-proven
hypertensive nephrosclerosis: a retrospective cohort study
#MMPMID27066888
Liang S
; Le W
; Liang D
; Chen H
; Xu F
; Chen H
; Liu Z
; Zeng C
BMC Nephrol
2016[Apr]; 17
(ä): 42
PMID27066888
show ga
BACKGROUND: This study aimed to investigate renal outcomes and their predictors
in biopsy-proven hypertensive nephrosclerosis (HN) patients and to compare
clinico-pathological characteristics and prognoses between benign nephrosclerosis
(BN) and malignant nephrosclerosis (MN) patients. METHODS: Data for biopsy-proven
HN patients were retrospectively analyzed. Renal survival rates and relationships
between clinico-pathological characteristics and outcomes were assessed. RESULTS:
A total of 194 patients were enrolled; the mean age at biopsy was 43.8 years, and
male gender predominated (82.5 %). The median duration of hypertension was
5.0 years, and the mean systolic and diastolic blood pressures were 195?±?37 and
126?±?26 mmHg, respectively. The median serum creatinine (Scr) level, estimated
glomerular filtration rate (eGFR), and proteinuria level were 1.61 mg/dl,
49.6 ml/min/1.73 m(2), and 0.80 g/24 h, respectively. BN and MN were found by
renal biopsy in 55.2 % and 44.8 % of patients, respectively. At biopsy, MN
patients were younger, and had higher median Scr and proteinuria levels, higher
incidences of anemia, hypertensive heart disease and hypertensive retinopathy,
and worse renal outcomes than BN patients. During a median follow-up period of
3.0 years, 36 patients (18.6 %) reached end-stage renal disease (ESRD), and the
5- and 10-year cumulative renal survival rates for HN patients were 84.5 % and
48.9 %, respectively. A decreased baseline eGFR, an increased baseline
proteinuria level, anemia, increased percentage of global glomerulosclerosis and
tubular atrophy and interstitial fibrosis (TAIF) were independent predictors of
future ESRD. CONCLUSIONS: The clinico-pathological characteristics and prognoses
were significantly different between the MN and BN patients. The renal outcomes
of HN patients were independently associated with the baseline eGFR and
proteinuria level, anemia, percentage of global glomerulosclerosis and TAIF.