Crises in primary arterial hypertension: kidney pathology role

Abstract

To investigate the prevalence of renal dysfunction and disorders in I-Ш Stage primary arterial hypertension, AH (WHO classification, 1997), complicated with AH crises, 563patients (189 men and 374 women aged 25-66 years) were examined. Control group included 619patients (207men and 412 women aged 31-66years) with non-crise Stage I-ШАН. Instrumental examination included renoradiography, static and dynamic renal scintigraphy, ultrasound and computed renal and suprarenal tomography, excretory urography, and selective renal artery angiography, if necessary. Glomerular filtration rate was assessed by endogenous creatinine clearance, and microproteinuria - by urinary excretion of albumin and beta-2-microglobulin. Aldosterone and cyclic nucleotide excretion, plasma renin activity were measured by radio-immune methods. Renal dysfunction and disorders were diagnosed in two-thirds of the patients with crise-characterized primary AH. Chronic mono- and bilateral inflammation and nephrosclerosis were the most prevalent disorders, followed by renal artery stenosis, disturbed renogram secretory phase, decreased functional parenchyma volume and terminal nephrosclerosis, accompanied by increased plasma renin activity. Nitro- and hydroextretory renal functions were not directly linked to AH crise development. Patients with frequent AH crises differed from participants with rare AH crises by such parameters as urinary white and red blood cell excretion, absorptive and excretory renal function.