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Revista da Associação Médica Brasileira

versão impressa ISSN 0104-4230versão On-line ISSN 1806-9282


LOPES, ANTONIO ALBERTO; SILVEIRA, MARCO ANTONIO; MARTINELLI, REINALDO  e  NOBLAT, ANTONIO CARLOS B.. Influence of hypertension on the incidence of end-stage renal disease in negroes and mulattoes with glomerulonephritis. Rev. Assoc. Med. Bras. [online]. 2002, vol.48, n.2, pp.167-171. ISSN 0104-4230.

OJECTIVE: To assess whether hypertension diagnosed during the first two months of follow-up is associated with the incidence of end-stage renal disease (ESRD) in negroes and mulattoes with glomerulonephritis after taking into account age, gender and the histological diagnosis.METHODS: A retrospective cohort study based on a sample of' 120 negro and mulatto patients with glomerulonephritis, 26 with membranoproliferative glomerulonephritis (MPGN), 58 with focal segmental glomerulosclerosis (FSG) and 36 with other types of glomerulonephritis (OTGN). Hypertension was considered present if antihypertensive treatment was used, in adults (age >18 years) with a mean of the three first systolic blood pressures of 140 mmHg or a mean of the corresponding diastolic blood pressure of 90 mm Hg or greater. For ages equal to or below 18 years the criteria recommended by the "Task Force on Blood Pressure in Children" were used.RESULTS: Hypertension was diagnosed in 48 of the 120 patients (41.6%). The incidence of ESRD was approximately 2.6 times higher in hypertensive patients (relative risk(RR)=2.62; 95 % confidence interval (CI) =1.01-7.03, p=0.031). This association between hypertension and higher risk of ESRD was similar between the group younger than 19 and the group older than 18 years. Even after adjusting for age, gender and histologic type, the incidence of ESRD remained higher (and marginally significant) in the hypertensive than in the normotensive group (adjusted RR=2.15; IC 95%=0.86-5.39, p=0.07).CONCLUSIONS: According to the findings, early detection of hypertension in negroes and mulattoes with glomerulonephritis helps to identify patients with higher risk of ESRD, independently of age, gender and histologic type. Further research is needed to determine to what extent the severity of hypertension and the degree of blood pressure control contribute to the development of ESRD in negroes and mulattoes with glomerulonephritis.

Palavras-chave : Hypertension; End-Stage Renal Disease; Glomerulonephritis; Race; Negroes; Mulattoes.

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