ABSTRACT
The renal histopathology of essential malignant phase hypertension in two groups of black South Africans was studied. The first, an autopsy series, consisted of material obtained in 1956-1961, a period when adequate antihypertensive therapy had not yet become generally available. The second group, a renal biopsy series, was from an era when effective antihypertensive therapy was available (1979-1989). The study showed that the clinical and histopathological changes of malignant hypertension were similar in both the pre-treatment and treatment eras. Fibrinoid necrosis was found in 92% of the autopsy sections and 44% of the biopsies. While mucinous, onion-skin and fibrotic changes of the blood vessels were commonly found, they were not invariably present and could not be considered the histopathological hallmark of malignant nephrosclerosis. It was often impossible on histological examination to distinguish malignant nephrosclerosis arising de novo from that superimposed on long-standing previous benign hypertension. Replication of internal elastic lamina, which has been considered a marker of long-standing previous benign hypertension, was a nonspecific finding and was frequently observed in young hypertensive subjects with a short clinical history. When fibrinoid necrosis is present, diagnosis of malignant nephrosclerosis can be made with confidence in black South Africans.
Subject(s)
Hypertension, Malignant/pathology , Kidney/pathology , Adult , Black People , Female , Humans , Male , Middle Aged , Nephrosclerosis/pathology , South AfricaSubject(s)
Acute Kidney Injury/etiology , Hypertension, Malignant/complications , Adult , Blood Pressure , Humans , Male , Peritoneal DialysisABSTRACT
The diagnosis of infective endocarditis may be difficult in the patient with renal failure. The usual source of infection is a septic vascular access site. We present a case in which endocarditis developed from an infected peritoneal dialysis catheter.
Subject(s)
Catheterization/adverse effects , Endocarditis, Bacterial/etiology , Peritoneal Dialysis/adverse effects , Adult , Humans , MaleSubject(s)
Arteriovenous Shunt, Surgical , Renal Dialysis , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle AgedABSTRACT
Continuous ambulatory peritoneal dialysis (CAPD) is being used with increasing frequency throughout the world as an alternative to long-term haemodialysis. The problems of 8 Black patients on CAPD are discussed, with special reference to their socioeconomic and home circumstances. CAPD has been successful in this group, suggesting that it may be used more extensively in developing populations.
