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Nephrol Dial Transplant (2000) 15: 1515-1517
© 2000 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Hypertensive nephrosclerosis–a cause of end-stage renal disease?

Friedrich C. Luft

Franz Volhard Clinic and Max Delbrück Center, Medical Faculty of the Charité, Humboldt University of Berlin, Germany

‘Hypertensive nephrosclerosis’ is moving up the charts to number 2 in terms of diagnostic frequency cited as causing end-stage renal disease (ESRD) in chronic dialysis patients; the entity was recognized as early as 1873 [1]. Type 2 diabetes mellitus holds first place and glomerulonephritis (all types) has fallen to third place in the ranking. The diagnostic criteria for type 2 diabetes and glomerulonephritis are relatively secure. Malignant hypertension with fibrinoid necrosis and relatively acute renal failure is a well understood pathological entity. However, hypertensive nephrosclerosis resulting from essential hypertension per se is far less clear.

Frequency of end-stage renal disease in hypertensive patients

There is no doubt that elevations of blood pressure are a strong independent risk factor for ESRD. The 332 544 men participating in the MRFIT study showed that a strong, graded relationship between systolic and diastolic blood pressure and the . . . [Full Text of this Article]

The renal histology of hypertension-related renal failure

Interaction between blood pressure and genetic background

A diagnostic mixed bag

Cholesterol microembolization

Fixing big vessels may not help

Conclusion

Notes

References


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