Short-term course of renal function in accelerated hypertension

Abstract

Thirty-four patients with primary accelerated hypertension were studied regarding the effect of BP on renal function and the association between fundal grade and renal function before treatment; and the changes in renal function on normalization of BP in 12 patients. Mean arterial pressure was negatively correlated with serum creatinine (r=-0.44, P<0.02) and there was no significant difference in serum creatinine or in the occurrence of renal failure between patients with grade III (n = 21) and grade IV (n = 13) retinopathy, (P = n.s. and X 2 = 0.172 P = n.s. respectively). Twenty-two patients required dialysis at presentation. Serum creatinine rose in 12 other patients on reduction of BP; 7 patients with serum creatinine level s 3.2 mg/dL (283 umol/L) at presentation never required dialysis in the 3 months following reduction of BP while those with levels I 3.6 mg/dL (319 umol/L) did. In accelerated hypertension, renal function is partly maintained by the blood pressure and dialysis may be required soon after presentation or normalization of BP.