BACKGROUND: Some studies have shown an improvement in the prognosis of patients with essential malignant hypertension (MHT), but data about long-term outcome and prognostic factors of these patients are scarce. METHODS: We performed a single-centre retrospective analysis of 197 patients with MHT, diagnosed in the period 1974-2007. RESULTS: Incidence of MHT remained stable along the different periods of the study. Renal damage at presentation was common (63% of patients) but renal function improved or remained stable after diagnosis in a majority of patients. The probability of renal survival was 84 and 72% after 5 and 10 years, respectively. Diagnosis during the first period (1974-85) of the study, previous chronic renal impairment, baseline renal function and proteinuria, presence of microhaematuria, systolic and diastolic blood pressure and proteinuria during follow-up were associated with an unfavourable outcome. By multivariate analysis, mean proteinuria during follow-up remained as the only significant risk factor (OR, 2.72; 95% CI, 1.59-4.64). Renal survival for patients with mean proteinuria <0.5 g/24 h was 100 and 95% after 5 and 10 years, respectively. The number of patients who improved or stabilized their renal function significantly increased in the second and third periods of the study (1987-2007). CONCLUSIONS: Renal survival in MHT has improved in recent years. Mean proteinuria during follow-up is a fundamental prognostic factor for renal survival.
BACKGROUND: Some studies have shown an improvement in the prognosis of patients with essential malignant hypertension (MHT), but data about long-term outcome and prognostic factors of these patients are scarce. METHODS: We performed a single-centre retrospective analysis of 197 patients with MHT, diagnosed in the period 1974-2007. RESULTS: Incidence of MHT remained stable along the different periods of the study. Renal damage at presentation was common (63% of patients) but renal function improved or remained stable after diagnosis in a majority of patients. The probability of renal survival was 84 and 72% after 5 and 10 years, respectively. Diagnosis during the first period (1974-85) of the study, previous chronic renal impairment, baseline renal function and proteinuria, presence of microhaematuria, systolic and diastolic blood pressure and proteinuria during follow-up were associated with an unfavourable outcome. By multivariate analysis, mean proteinuria during follow-up remained as the only significant risk factor (OR, 2.72; 95% CI, 1.59-4.64). Renal survival for patients with mean proteinuria <0.5 g/24 h was 100 and 95% after 5 and 10 years, respectively. The number of patients who improved or stabilized their renal function significantly increased in the second and third periods of the study (1987-2007). CONCLUSIONS: Renal survival in MHT has improved in recent years. Mean proteinuria during follow-up is a fundamental prognostic factor for renal survival.
Authors: Sjoerd A M E G Timmermans; Myrurgia A Abdul-Hamid; Judith Potjewijd; Ruud O M F I H Theunissen; Jan G M C Damoiseaux; Chris P Reutelingsperger; Pieter van Paassen Journal: J Am Soc Nephrol Date: 2018-06-01 Impact factor: 10.121
Authors: A Cremer; F Amraoui; G Y H Lip; E Morales; S Rubin; J Segura; B J Van den Born; P Gosse Journal: J Hum Hypertens Date: 2015-11-19 Impact factor: 3.012
Authors: Jean Astrid Aka; Cyr Monlet Guei; Serge Didier Konan; Patrick Sery Diopoh; Syndou Sanogo; Hubert Kouamé Yao Journal: Pan Afr Med J Date: 2021-03-24