A FAMILY HISTORY OF HYPERTENSION IS ASSOC IATED WITH THE DEVELOPMENT OF HYPERTENSION AND NEPHROANGIOSCLEROSIS IN PATIENTS WITH GLOMERULONEPHRITIS DUE TO MESANGIAL IGA DEPOSITS

The progress of IgA Nephropathy (IgAN) is correlated with glomerular a nd vascular sclerosis. Renal vascular lesions, i.e. nephrosclerosis, o ften precede the onset of hypertension (HBP) in young patients with Ig AN. It is also recognized that a family history of HBP (FHBP) is stron gly predictive of future onset of HBP in family members, when two or m ore first-degree relatives with HBP are identified. In order to examin e the possible link between FHBP and nephrosclerosis, we compared 2 gr oups of 29 pts each (23 M and 6 F) with IgAN, matched for age and sex, according to the presence or absence of FHBP. FHBP was considered pre sent if at least 2 or more Ist degree relatives under 60 years of age received antihypertensive Rx. Parents and siblings of patients were ex amined at home by tow investigators. Patients with FHBP (+) and FHBP ( -) were aged 36+/-12 and 35+/-12, respectively, at the time of renal b iopsy and the follow-up was conducted for an average of 4.6 years. At the end of this survey, HBP and renal failure (Cr Cl <80 ml/min) were reevaluated in all patients. At the time of renal biopsy, nephrosclero sis was significantly associated with FHBP: FHBP(+):96.5% versus FHBP( -):10.3%; p <0.0001. At the end of the follow-up, FHBP was found to be associated with HBP (89.6% versus 10.3%; p <0.0001) and with renal fa ilure (44.8% versus 3.4%; p <0.001). These data suggest that nephroscl erosis has a strong genetic component in patients with IgAN, FHBP is a n early clinical indicator of nephrosclerosis in these patients and th at FHBP is a strong indicator of unfavorable prognosis in IgAN.