Determination of optimal blood pressure for patients with IgA nephropathy based on renal histology

Citation
Y. Osawa et al., Determination of optimal blood pressure for patients with IgA nephropathy based on renal histology, HYPERTENS R, 24(2), 2001, pp. 89-92
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
Hypertension research
ISSN journal
0916-9636 → ACNP
Volume
24
Issue
2
Year of publication
2001
Pages
89 - 92
Database
ISI
SICI code
Abstract
To evaluate the optimal BP control for patients with IgA nephropathy (IgAN) based on the histologic severity of the nephropathy and the degree of rena l dysfunction. We analyzed 332 consecutive renal biopsy specimens and clini cal data from patients with IgAN. Patients were divided into three groups b ased on their BP at the time of biopsy: an optimal BP (SBP<120 mmHg and DBP <80 mmHg), a hypertensive BP (SBP greater than or equal to 140 mmHg and/or DBP greater than or equal to 90 mmHg), and an intermediate BP group. Each b iopsy specimen was evaluated for mesangial proliferation, degree of scleros is and/or hyalinosis of the arterioles and the interlobular artery using a semiquantitative method. Creatinine clearance and the percentage of scleros ed glomeruli were also determined. Both the degree of renal dysfunction and the histologic changes correlated significantly with BP, even in patients with a BP <140/90 mmHg, The patients with an optimal BP at the time of biop sy had significantly less histologic damage with respect to mesangial proli feration and vessel changes than those with an intermediate or hypertensive BP, In the patients with a hypertensive BP, the percentage of sclerotic gl omeruli was significantly higher and the creatinine clearance was significa ntly lower. The optimal BP proposed by the WHO in 1999 prevents histologic evidence of renal damage for patients with IgAN.