ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical and pathological characteristics of patients with clinically presumed hypertensive nephrosclerosis (HN).</p><p><b>METHODS</b>Clinical data and renal biopsy results were obtained in 63 patients diagnosed clinically as HN (primary hypertension plus renal injury).</p><p><b>RESULTS</b>HN was confirmed by biopsy in 47 out of 63 patients (74.6%, 12 malignant nephrosclerosis and 35 benign nephrosclerosis). Primary nephritis (PN) was diagnosed by biopsy in 10 patients (7 IgA nephropathy, 2 mesangial proliferative nephritis, 1 chronic interstitial nephritis) and focal and segmental glomerulosclerosis (FSGS) in 6 patients. Blood pressure, body mass index, GFR and blood lipids were similar among groups. HN patients were related to higher age, more frequent family history of hypertension, longer hypertension duration, higher left ventricular mass index, lower serum creatinine and lower incidence of microscopic hematuria. Most patients with malignant nephrosclerosis and FSGS patients showed grades III and IV retinopathy.</p><p><b>CONCLUSION</b>Our results show that HN was misdiagnosed in nearly 25% patients in this cohort. Since the clinical features are similar between HN, PN and FSGS, renal biopsy is needed to establish the diagnosis of HN.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Hypertension, Renal , Diagnosis , Pathology , Kidney , Pathology , Nephrosclerosis , Diagnosis , PathologyABSTRACT
<p><b>OBJECTIVE</b>To study the effect of long-term use of low dose Caulis Aristolochiae Manshuriensis (CAM) on the deterioration of chronic renal failure rats.</p><p><b>METHODS</b>The 5/6 nephrectomized Wistar rats were taken as animal model of chronic renal failure, which were divided into 3 groups. Group A was treated with 1 g/kg CAM decoction, the dose equivalent to that defined in the pharmacopoeia. Group B was treated with 3 g/kg CAM decoction and Group C treated with equal volume of tap water. Medication was given once per day by gastrogavage in all the three groups for 8 weeks. The serum creatinine, urea nitrogen, urinary protein content and morphological changes of kidney were observed.</p><p><b>RESULTS</b>After 8 weeks treatment, levels of serum creatinine, urea nitrogen, urinary protein excretion in Group B were higher than those in Group C significantly, they were 165.0 +/- 15.6 mumol/L vs 109.8 +/- 10.0 mumol/L, 27.8 +/- 3.6 mmol/L vs 18.7 +/- 2.5 mmol/L and 68.2 +/- 10.1 mg/24 hrs vs 44.6 +/- 8.5 mg/24 hrs, respectively, all P < 0.05. The pathological changes of renal mesenchyme and degree of glomerulosclerosis were also heavier in Group B.</p><p><b>CONCLUSION</b>The susceptibility of chronic renal failure rats to the nephrotoxicity of CAM increases in long-term use of low dose CAM which could accelerate the deterioration of renal impairment in the model rats.</p>