RENAL VASCULAR-DISEASE CAUSING END-STAGE RENAL-DISEASE, INCIDENCE, CLINICAL CORRELATES, AND OUTCOMES - A 20-YEAR CLINICAL-EXPERIENCE

被引:296
作者
MAILLOUX, LU
NAPOLITANO, B
BELLUCCI, AG
VERNACE, M
WILKES, BM
MOSSEY, RT
机构
[1] N SHORE UNIV HOSP,CORNELL UNIV MED COLL,RES DEPT,DIV BIOSTAT,MANHASSET,NY 11030
[2] CORNELL UNIV,COLL MED,DEPT MED,MANHASSET,NY 11030
[3] CORNELL UNIV,COLL MED,DEPT PUBL HLTH,MANHASSET,NY 11030
关键词
RENAL VASCULAR DISEASE; END-STAGE RENAL DISEASE; SURVIVAL; CO-MORBID RISK FACTORS;
D O I
10.1016/S0272-6386(12)80223-X
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
In the United States, the incidence of end-stage renal disease to hypertension has increased sharply over the last 8 years, especially in elderly white dialysis patients who demonstrate very poor survival rates. The 5-year survival rates were near 20% for patients 65 to 74 years old and 9% for those greater than or equal to 75 years of age. Our program experienced a sharp increase in cases of end-stage renal disease due to renal vascular disease after 1982. Penal vascular disease was characterized clinically in 83 of 683 dialysis patients either by angiography or asymmetric kidney size in patients with evidence of systemic atherosclerosis, hypertension, insignificant proteinuria, and a benign urinary sediment. The median age was 70 years, with 84% of the patients being older than 61 years. These patients had 56% 2-year, 18% 5-year, and 5% 10-year survival rates, which are quite similar to the 1992 US Renal Data System data. Patients with renal vascular disease have a significantly worse prognosis than other diagnostic groups, most likely due to their older age, underlying vascular disease, and coronary artery disease. We feel that a significant number of elderly white hypertensive patients described in the 1992 US Renal Data Service report have renal vascular disease as a cause of end-stage renal disease, highlighting the need to establish correct renal diagnoses. Hypertension should not be the end-stage renal disease diagnosis in elderly white hypertensive patients if clinical criteria suggest a diagnosis of renal vascular disease. (C) 1994 by the National Kidney Foundation, Inc.
引用
收藏
页码:622 / 629
页数:8
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