PREVALENCE OF HYPERTENSIVE NEPHROSCLEROSIS BY A 10-YEAR LONG KIDNEY BIOPSY DATABASE OF SZEGED NEPHROLOGY-HYPERTENSION CENTER

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Objective: Hypertension is the second most frequent cause of end stage renal disease and dialysis treatment. But there are no exact data about prevalence of real hypertensive nephrosclerosis (HNS). Design and method: We retrospectively analyzed the kidney biopsy database of the Szeged Nephrology-Hypertension Center of the 1st Department of Medicine from 01/01/2007 to 31/12/2016. In all cases, we recorded the clinical ideas, the histology findings, the existence of hypertension. Results: The total number of kidney biopsies was 451 (1 biopsy/patient), on left kidney 441 and on the right kidney 10. The mean number of punctures was 3. The mean age at the time of biopsy was 48.7 ± 15 years (male 43.5% and female 56.5%). Hypertension was frequent among these patient, 336 of them had hypertension. The most frequent clinical indication was the nephrotic syndrome (38.8%) and the nephritic syndrome (24.25%). Prior idea for a histology diagnosis were only in 303 patients, but the number of ideas was higher, 614. The prevalence of HNS among these clinical ideas was very low, only 0.5% (3/614). Of the 451 patients had 485 histology diagnoses. The prevalence of HNS was hihger among the histology diagnoses, 2.2% (10/485). The HNS as histology diagnosis was most frequent in the age of 40–49 years (1.24%) and in the age of 50–59 years (0.4%). HNS had higher prevalence among women vs. men (1.3% vs. 0.8%). Analyzing the indications of biopsies the HNS was most ferquent in isolated proteinuria (1.0%), but in nephritic syndrome and renal failure with unknown origin it's prevalence was just 0.4%. In 85 patients the final histology diagnosis was not listed among their prior ideas. These patients had 92 histology diagnoses we named unexpected diagnoses. Among them the prevalence of HNS was 3.3%. Conclusions: More patients have got hypertension compared to the histology findings. Just because of an idea of HNS usually we are not performing a kidney biopsy. Not all the hypertensives have got HNS, but it is more common at the background of isolated proteinuria.

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