[Clinical and pathological characteristics in patients with clinically presumed hypertensive nephrosclerosis].
OBJECTIVE
To investigate the clinical and pathological characteristics of patients with clinically presumed hypertensive nephrosclerosis (HN).


METHODS
Clinical data and renal biopsy results were obtained in 63 patients diagnosed clinically as HN (primary hypertension plus renal injury).


RESULTS
HN was confirmed by biopsy in 47 out of 63 patients (74.6%, 12 malignant nephrosclerosis and 35 benign nephrosclerosis). Primary nephritis (PN) was diagnosed by biopsy in 10 patients (7 IgA nephropathy, 2 mesangial proliferative nephritis, 1 chronic interstitial nephritis) and focal and segmental glomerulosclerosis (FSGS) in 6 patients. Blood pressure, body mass index, GFR and blood lipids were similar among groups. HN patients were related to higher age, more frequent family history of hypertension, longer hypertension duration, higher left ventricular mass index, lower serum creatinine and lower incidence of microscopic hematuria. Most patients with malignant nephrosclerosis and FSGS patients showed grades III and IV retinopathy.


CONCLUSIONS
Our results show that HN was misdiagnosed in nearly 25% patients in this cohort. Since the clinical features are similar between HN, PN and FSGS, renal biopsy is needed to establish the diagnosis of HN.
Guo
Yun-shan
YS
Department of Nephrology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Yuan
Wei-jie
WJ
Yu
Jian-ping
JP
Mei
Xiao-bin
XB
Ye
Han-yang
HY
Bian
Qi
Q
Xu
Jing
J
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009400:Nephrosclerosis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*