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Does renal function improve after diagnosis of malignant phase hypertension?
G Y Lip1, M Beevers, D G Beevers
1University Department of Medicine, City Hospital, Birmingham, UK.
Journal of Hypertension
|December 31, 1997
Summary
Malignant hypertension (MHT) can cause progressive kidney damage, even with controlled blood pressure. However, some patients with severe MHT show stable or improved renal function, indicating blood pressure control is key for outcomes.
Area of Science:
- Nephrology
- Cardiology
- Hypertension Research
Background:
- The relationship between hypertension and kidney damage is debated, with differing views on whether essential hypertension causes renal damage.
- Malignant hypertension (MHT) often leads to progressive renal impairment, despite potential dissociation between short-term function changes and long-term outcomes.
- MHT associated with renal impairment carries a grave prognosis.
Purpose of the Study:
- To investigate changes in renal function following a diagnosis of Malignant Hypertension (MHT).
Main Methods:
- Studied clinical features, renal function, and survival of 169 MHT patients.
- Categorized patients based on initial serum creatinine: Group 1 (<300 µmol/L) and Group 2 (≥300 µmol/L).
- Classified patients by renal function change at follow-up: Group A (deterioration) and Group B (stable/improved).
Main Results:
- 56.8% of patients experienced a rise in serum creatinine during follow-up.
- Patients with initially mild-to-moderate impairment (Group 1) showed significant renal function deterioration (P=0.001).
- Patients with severe initial impairment (Group 2) had shorter survival (15 vs 59 months, P=0.0001).
Conclusions:
- Renal function can continue to decline in some MHT patients despite blood pressure control.
- A significant proportion of patients with severe initial renal impairment showed stable or improved function.
- Effective blood pressure control at follow-up, not initial severity, predicted patient outcomes.