The pathological basis of end-stage renal disease in blacks.

In a series of 115 black patients admitted to a chronic haemodialysis programme over a 4-year period, a definitive pathological diagnosis was made in 70 cases. Of these, 5 were made anatomically while in 65 the diagnosis was histological. The commonest single cause of end-stage renal disease was essential malignant hypertension which showed a peak incidence in males aged 40 - 50 years. Chronic pyelonephritis and other diseases prominent in series of White patients were conspicuously absent. The prevalence of malignant hypertension presents a challenge for the detection and treatment of such cases by the community health services.