Outcome of patients with malignant hypertension and end-stage renal failure treated by long-term hemodialysis

Malignant hypertension is associated with high mortality and morbidity usua lly caused by cardiovascular events. The course and prognosis of malignant hypertension patients treated with renal replacement therapy has not been t horoughly investigated. In the present work, we compared the clinical evolu tion and survival of 24 endstage renal failure malignant hypertension patie nts with that of a group of individually matched renal failure patients adm itted to the same dialysis center during a period of 21 years. Survival rat es at 1, 5 and 8 years were 87, 82 and 50% for malignant hypertension patie nts and 87, 75 and 65% for controls, respectively (p = 0.766, NS). Nonfatal cardiovascular complications occurred in 2 individuals of each group. The most important cause of death in both groups was cardiovascular. The freque ncy of fatal cardiovascular events was similar in the two groups: 64% of de aths for malignant hypertension and 71% for controls (NS). In conclusion, p revious malignant hypertension did not increase the risk of patients in lon gterm hemodialysis in our series.