THE ROLE OF ARTERIAL-HYPERTENSION IN PROGRESSION OF RENAL-FAILURE

The effect of arterial hypertension on the progression of chronic rena l failure (CRF) was evaluated in 108 patients who eventually required dialysis in the 6 year period of the study. Patients' average serum cr eatinine (S-Cr) concentration at first examination was 239.7 +/- 45.3 mu mol/liter and at the start of dialysis was 1,661.0 +/- 181.9 mu mol /liter. The mean duration of pre-dialysis follow-up was 53.7 +/- 15.7 months. The mean monthly increase in S-Cr was 18.8 +/- 13.4 and 2.1 +/ - 1.4 mu mol/liter/month in hypertensive and normotensive CRF patients , respectively (P < 0.001). The CRF patients with a diastolic blood pr essure (BP) < 89 mm Hg had a significantly (P < 0.05) slower rate of d ecline in renal function than the patients with a diastolic BP greater than or equal to 90 mm Hg. There was a significant relationship betwe en a mean diastolic BP greater than or equal to 90 mm Hg and the rate of monthly increase in S,, (r = 0.81. P < 0.001). These data indicate that control of diastolic BP in CRF patients is a potentially effectiv e way to slow the rate of decline in renal function.