Malignant Hypertension Presenting With Real Damage:a Clinical And Pathological Features

Objective To find out the clinical features and pathological characteristics of malignant hypertension(MHT) with renal damage. Method The patiens with MHT hospitalized in our department from 1990 to 2004,were analyzed their clinical and pathological features. Results There were 24 patients. All the patients suffered from MHT.The ratio of male to female was 2.43:1.The average age was(28.5±7.7)years old.Primary hypertension was diagnosed in 5 cases,glomerulonephritis in 19 cases.Renal biopsy was done in 8 cases.IgA nephropathy was the most common pathological type.The rates of recognition of hypertension before MHT onset were 75.7%.They present levels of urinary protein.5 cases have most of urinary protein(>3.5g/24h).Severe glomerulonephritis,hyalinosis and thickening of renal arterioles were the main changes in MHT with renal parenchymal disease.After intensive therapy,the renal functions of some primary MHT patients improved markedly. Conclusion Malignant hypertension presenting with renal damage was not very rare,especially in glomerulonephritis hypertension, which becomes an important reason inducing rapidly decrease of renal function.We should emphasis on renal biopsy.