PMID- 25611832
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20161230
IS  - 1989-2284 (Electronic)
IS  - 0211-6995 (Linking)
VI  - 35
IP  - 1
DP  - 2015
TI  - Malignant hypertension: a type of IgA nephropathy manifestation with poor 
      prognosis.
PG  - 42-9
LID - 10.3265/Nefrologia.pre2014.Oct.12735 [doi]
AB  - INTRODUCTION:  Malignant hypertension (MHT) is an uncommon clinical 
      manifestation of IgA Nephropathy (IgAN). Its prevalence, pathogenesis and 
      evolution are not well known.  MATERIAL AND METHODS:  We performed a 
      descriptive and retrospective study to report the clinical characteristics and 
      evolution of thirteen patients diagnosed as having IgA nephropathy by renal 
      biopsy in our hospital who developed MHT (IgAN-MHT).  RESULTS:  The 
      prevalence of MHT in our IgAN patients was 7% (13/186). The mean age was 
      37±12 years and 84% were males. Mean systolic/diastolic blood pressure at 
      presentation were 219±32/132±18mmHg, respectively. Renal function 
      impairment was detected at admission in all the patients, with a mean serum 
      creatinine of 4.73±3.12mg/dL. No patient showed analytical data that 
      suggested thrombotic microangiopathy. Renal biopsies showed mild chronicity 
      lesions and only four patients presented features of thrombotic microangiopathy. 
      All patients were treated with renin-angiotensin-aldosterone blockers and two 
      received steroids. They all showed a progressive loss of renal function. At the 
      end of follow up one patient had died, ten were on chronic dialysis and two 
      presented chronic kidney disease stage 3b. Renal survival was 69% and 35% at 3 
      and 6 years, respectively. Six patients received a kidney transplant: IgAN 
      relapsed in four patients. One of them presented a new episode of MHT associated 
      with a HELLP syndrome.  CONCLUSIONS:  Malignant hypertension is a form 
      of IgAN clinical presentation having a remarkably worse renal outcome and without 
      specific effective treatment.
FAU - Sevillano, Angel M
AU  - Sevillano AM
FAU - Cabrera, Jimena
AU  - Cabrera J
FAU - Gutierrez, Eduardo
AU  - Gutierrez E
FAU - Morales, Enrique
AU  - Morales E
FAU - Merida, Evangelina
AU  - Merida E
FAU - Huerta, Ana
AU  - Huerta A
FAU - Cavero, Teresa
AU  - Cavero T
FAU - Hernandez, Eduardo
AU  - Hernandez E
FAU - Moreno, Juan A
AU  - Moreno JA
FAU - Praga, Manuel
AU  - Praga M
LA  - eng
LA  - spa
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Spain
TA  - Nefrologia
JT  - Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia
JID - 8301215
SB  - IM
MH  - Adult
MH  - Biopsy
MH  - Female
MH  - Glomerulonephritis, IGA/*complications
MH  - Humans
MH  - Hypertension, Malignant/epidemiology/*etiology
MH  - Kidney/pathology
MH  - Kidney Failure, Chronic/etiology/surgery/therapy
MH  - Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Prognosis
MH  - Renal Dialysis
MH  - Renin-Angiotensin System/drug effects
MH  - Retrospective Studies
MH  - Thrombotic Microangiopathies/etiology
MH  - Young Adult
EDAT- 2015/01/23 06:00
MHDA- 2016/12/15 06:00
CRDT- 2015/01/23 06:00
PHST- 2014/10/20 00:00 [accepted]
PHST- 2015/01/23 06:00 [entrez]
PHST- 2015/01/23 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - 10.3265/Nefrologia.pre2014.Oct.12735 [doi]
PST - ppublish
SO  - Nefrologia. 2015;35(1):42-9. doi: 10.3265/Nefrologia.pre2014.Oct.12735.