MORPHOLOGICAL ALTERATIONS TO THE KIDNEYS IN ARTERIAL HYPERTENSION COMBINED WITH MILD PROTEINURIA

Abstract

THE AIM of the investigation was to comparatively describe renal lesions in patients with arterial hypertension (AH) and mild proteinuria who had hypertonic nephroangiosclerosis or mesangial-proliferative glomerulonephritis diagnosed when investigating the kidney bioptates. PATIENTS AND METHODS. Under study there were 81 patients who had AH in combination with mild proteinuria that was considered as an indication to nephrobiopsy. The patients were divided into two groups of comparison: patients with essential hypertension (EH, n=42) in whom the morphological data had undoubtedly shown nephroangiosclerosis and patients with mesangial-proliferative glomerulonephritis (MPGN, n=39). Nephrobioptates were investigated at the level of standard light microscopy. Additional semi-quantitative assessment of some signs of lesions to the kidneys was made. RESULTS. Patients with EH of older age, had longer AH and higher values of arterial pressure (AP). Patients with EH had considerably lower glomerular filtration rate than patients with MPGN with comparable values of proteinuria. The degree of nonspecific glomerular, vascular and tubulointerstitial lesions of the kidneys in patients with EH was also higher than in patients with MPGN. More distinct direct correlation was noted between the levels of AP and morphological signs demonstrating lesions of the microcirculatory bed of the kidneys. CONCLUSION. The data obtained confirm that hypertonic nephroangiosclerosis is not infrequently accompanied by proteinuria and the degree of morphological alterations to the kidneys in patients with AH of different nature is associated with the level of AP.