The long-term prognosis of benign nephrosclerosis accompanied by focal glomerulosclerosis and renal cortical interstitial fibrosis, designated so-called decompensated benign nephrosclerosis by Fahr, Bohle and Ratscheck.
The long-term prognosis of decompensated benign nephrosclerosis (DBN) was investigated by a retrospective analysis of the fate of 170 patients with this disease, which yielded the following results: 1) DBN carries a particularly poor prognosis. The renal survival rate (RSR) was 35.9% at 5 years and 23.6% at 10 years. The prognosis is therefore worse than that of any other primary glomerulopathy, with the exception of rapidly progressive glomerulonephritis. 2) DBN mainly affects males (sex ratio 5:1) and differs in this respect, among others, from focal sclerosing glomerulonephritis, in which the male:female ratio is 1.2:1. 3) The prognosis for females is no better than for males. 4) The severity of proteinuria at the time of biopsy has no influence on the prognosis. 5) The prognosis is particularly poor in cases in which the serum creatinine concentration is already elevated to more than 2.0 mg% at the time of biopsy. We conclude from these findings that not only the blood pressure, but also the serum creatinine concentration, should be assessed at regular intervals in all hypertensive individuals, so that DBN can be treated at an early stage, when it is still amenable to treatment.
Institute of Pathology, University of Tübingen, Germany.
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M
Wehrmann
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Bohle
D000328:Adult; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005355:Fibrosis; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007672:Kidney Cortex / Q000473:pathology*; D008297:Male; D009400:Nephrosclerosis / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D011507:Proteinuria / Q000652:urine; D012189:Retrospective Studies; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis
D003404:Creatinine