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ISSN 1561-3186 (Electronic)

2009, Number 1

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Rev Acta Médica 2009; 12 (1)

High Blood Pressure as cause of chronic renal disease by necropsy protocols studies

Fernández AMA, Álvarez SR, Vázquez VA, Méndez RA, Vázquez CA

Language: Spanish
References: 25
Page:
PDF size: 72.10 Kb.


ABSTRACT

A descriptive and retrospective study was carried out in hypertensive patients deceased over eleven years to assess the high blood pressure impact on the kidney in chronic renal disease. Cohort included 2 437 hypertensive deceased patients diagnosed with chronic renal disease. Study variable were: age, sex, direct, basic, and contributing death cause, coincidence between clinical diagnosis and the anatomical-pathological one. A database was established in managing Microsoft 2003 Access. To determine the coincidence between clinical diagnosis and the anatomical one, the coincidence percentages (total, partial non-coincidence and insufficient) were calculated, and its 95% confidence intervals. We noted that from the 2 427 hypertensive deceased patients, in 424 (17,4%) was present a chronic renal disease, the 61.6% were aged over 54, and that 222 (52.4%) were of male sex. Association between high blood pressure and chronic renal disease was the death basic cause in the 84,0% and the contributing one was of 46,2%. The 42,63% of hypertensive patients had signs of renal vascular disease or hypertensive nephroangiosclerosis, and from these ones, the 34,1% developed clinical manifestations of chronic renal disease. We conclude that high blood pressure is a etiological determinant factor very essential in appearance and progression of chronic renal disease, and that the interaction of high blood pressure and chronic renal disease is a significant link as basic and contributing death cause. Mortality analysis based on necropsy results is higher as regards quality compared to that carried out based on death certificates since it shows the true death cause as well as all morphologic alterations founded.


REFERENCES

  1. Mac Mahon S. Blood pressure and the risk of cardiovascular disease. N Engl J Med. 2000; 342:50-1.

  2. Lewington S, Clarke K, Qizilbash N, Peto R, Collins R. Age specific relevance of usual blood pressure to vascular mortality. Lancet. 2002; 360:1903-13.

  3. Kannel WB. Fifty years of Framinghan Study contributions to understanding hypertension. J Hum Hypertens. 2000; 14:83-90.

  4. Boresntein J. Physician Practice Patterns in the Treatment of Isolated Systolic Hypertension in a Primary Care Selting. J Clin Hypertens. 2002; 4:93-160.

  5. Ruilope LM, Salvetti A, Jamerson K, Hansson K, Warnold I, Wedel H. Renal function and intensive lowering of blood pressure in hepertensive participants of the Hypertension Optimal Treatment (HOT) study. Jam Soc Nephtal. 2001; 12: 218-25.

  6. Bakris GL, Williams M, Dworkin L, Elliott WJ, Epstein M, Toto R, for the National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61.

  7. Jacobson H. Ischemic renal disease. Kidney Int 1988; 34:729-43.

  8. Alcazar JM, Rodicio IL. Isqhemic nephropathy; clinical characteristics and treatmen. Am J Kidney Dis. 2000; 36:883-93.

  9. Klag Mj, Whelton Pk, Randall Bl, Neaton JD, Brancati Fl, Ford C. E, Blood pressure and end-stage renal disease in men. N. Engl J. Med. 1996; 334: 13-8.

  10. Multiple Risk Factor Intervention Trial. Mortality after 10 years for hypertensive participants in the Multiple Risk Factor Intervention Trial. Circulation. 1990; 82: 1616- 28.

  11. Mann JFE, Gerstein HC, Pogue J, Bosch J, Yusuf S. For the Hope Investigators. Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomized trial. Ann Intern Med. 2001; 134:629-36

  12. Guerra A, Pérez MD, Vázquez A, Cordies L. Epidemiología de la hipertensión arterial en Cuba. Rev Española de Nefrología. 2000; 20(Supl 6):43-9.

  13. Joint National Committee on Prevention Detection, Evaluation, and Treatment of High Blood Pressure. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. JAMA. 2003; 289:2560-72.

  14. Hurtado de Mendoza AJ, Álvarez Santana R, Jiménez López A, Fernández Pérez LG. El SARCAP. Sistema Automatizado de Registro y Control de Anatomía Patológica. Rev Cubana Med Milit. 1995; 24:123-30.

  15. OPS/OMS. Manual de Clasificación Estadística Internacional de Enfermedades, Traumatismos y Causas de Defunción. Clasificación Internacional de Enfermedades. Washington DC, 1978:51-503.

  16. Cotran RS, Kumar V, Collin T: Robbins. Patología estructural y funcional. Sexta edición Mc Graw-Hill-Interamericana de España. SAU. 2000; 1024-26.

  17. Snyder S, Pendergraph B. Detection and Evaluation of chronic kidney disease. American Family Physician. 2005; 72(9):1723-25.

  18. Coca A, De la Sierra A. La hipertensión arterial como factor de riesgo cardiovascular. En: Coca A , decisiones clínicas y terapéuticas en el paciente hipertenso 3er ed . Barcelona: Editorial jims, 2002. P. 3-15.

  19. Chobanian AV , Bakris GL, Black HR. Joint National Committee on Prevention , Detection, Evaluation and Treatment of High Blood Pressure . National Heart , Lung and Blood Institute. National High Blood Pressure Education Program Coordinating Committee . Seventh report of the Joint National Committee on Prevention , Detection , Evaluation and Treatment of High Blood Pressure. Hypertension. 2003; 42:1206-52.

  20. Kearney PM, Whelton M , Reynodls K . Global burden of hypertension: Analysis of wordwide data. Lancet. 2005; 365:217-23.

  21. Kearney PM, Whelton M, Reynolds K, et al. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004; 22:11-19.

  22. United States Renal Data survey. Annual data report. 2003. Online february. Disponible en: http://www.usrds.org/adr_2003.htm

  23. National kidney Foundation. K/DOQI, clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis. 2002; 39(2Suppl1):51-266. online February 15, 2005, at: www.kidney.org/professionals/kdoqi/guidelines_ckd/toc.htm

  24. National kidney Foundation. KEEP, kidney Early Evaluation Program. Annual data report. Program introduction Am J Kidney Dis. 2003; 42(5Suppl4):55-115. online February 15, 2005, at:http://www.kidney.org/keep/pdt/ajkd_keep_nov_2003.pdf

  25. US Renal Data System: USRDS 2000 Annual Report. Bethesda. MD National Institutes of Health, National Institutes of Diabetes and Digestive and Kidney Disease. 2000.




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