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      Partial Recovery of Renal Function in Black Patients with Apparent End-Stage Renal Failure due to Primary Malignant Hypertension


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          We report the largest series in which 12 out of 54 patients with primary malignant hypertension requiring dialysis recovered sufficient renal function to allow withdrawal of dialysis. The patients were divided into recovery (RC; n = 12) and non-recovery (N-RC; n = 42) groups. The two groups were compared for variables which might predict RC. They were also assessed for survival. Nine of the RC and 6 of the N-RC patients presented with acute oliguria (p = 0.01). The initial mean arterial pressure was significantly higher in the RC than the N-RC group (178 ± 17 vs. 160 ± 27 mm Hg; p = 0.03). Although not statistically significant, more females recovered (8 of 12 vs. 16 of 42; p < 0.1). More patients presenting with serum creatinine concentrations < 1,000 μmol/l (11 mg/dl) recovered (p = 0.09), while the presence of microangiopathic-haemolytic anaemia occurred more frequently in the RC (7 of 10) than in the N-RC (15 of 35) group (p = 0.16). Age, kidney size, and the presence of hypertensive retinopathy did not distinguish between the two groups. RC patients had a greater long-term survival (Mantel-Cox χ<sup>2</sup> = 4.48; p = 0.03). The renal function RC may be related to the type of dialysis provided (intermittent peritoneal dialysis) and to the use of modern potent peripheral vasodilator antihypertensive agents. Potential renal function RC should always be considered in patients being dialyzed for primary malignant hypertension.

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          Author and article information

          S. Karger AG
          18 December 2008
          : 71
          : 1
          : 29-34
          aDivision of Nephrology, Department of Medicine, University of the Witwatersrand Medical School, and bInstitute for Biostatistics, South African Medical Research Council, Johannesburg, South Africa
          188670 Nephron 1995;71:29–34
          © 1995 S. Karger AG, Basel

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          : 14 July 1994
          Page count
          Pages: 6
          Original Paper

          Cardiovascular Medicine,Nephrology
          Peritoneal dialysis,Primary malignant hypertension,Renal failure – acute, chronic


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