A Clinical Analysis Of 54 Cases Of Renal Damage Due To Malignant Hypertension

Background: Hypertension is the most common cardiovascular disease in our country, and also one of the most important epidemial diseases. Kidney diseases induce hypertension, and hypertension aggravates the kidney damages. The data from the United States Renal Data System (USRDS) shows that hypertension is the second etiological factor of end-stage renal disease (ESRD), and the morbility is increasing gradually. The morbility of hypertension is also increasing year by year in our country. ESRS may become one of the predominant related diseases influencing the life of the hypertension patients. Malignent hypertension, the morbility of which is 1%～4% in the hypertension group, is a type of hypertension emergency. It can induce serious damages to kidney, otherwise, renal parenchyma and renal vascular diseases are important factors causing malignant hypertension. Victims without therapy in time may just survive 4～5months in average, annd the primary cause of death is the acute renal failure(ARF). Nowadays there are still insufficient deep analyses and investigations in MHT with renal damage in our contry.Objective: To evaluate the clinical characteristics of malignant hypertension (MHT) with renal damage.Methods: 54 cases of MHT with renal damage patients, who had been hospitalized in recent 11 years, were analyzed retrospectively. The clinical feature and effective of treatment were compared with different causes. Results: Among 54 patients, primary hypertension was diagnosed in 25 cases, renal parenchymal MHT in 14 cases, renovascular hypertension in 4 cases, adrenal adenoma in 2 cases, gestation hypertension syndrome in 1 case, and undetermined etiology in 8 cases. Compared with those who were diagnosed as primary MHT patients, renal parenchymal MHT patients had higher urinary protein excretion (p<0.05) and more hematuria; control of hypertension was not so easy; and had rapidly decrease of renal function. Those patients that suffer from other causes MHT, such as adrenal adenoma, were comparatively good in prognosis.Conclusion: The causes of malignant hypertension and whether the blood pressure can be controlled equability correlated to the prognosis.