DOES TREATED MILD-TO-MODERATE ESSENTIAL HYPERTENSION CAUSE RENAL FAILURE?
Few studies have evaluated the incidence of renal failure from treated nonmalignant essential hypertension17,23,24. Siewert-Delle et al17 analyzed the development of renal disease in 686 white men with treated hypertension during a 20-year follow-up. Incidence of a serum creatinine level above 1.5 mg/dL was observed in 8.9% of patients, but an underlying renal abnormality was found in the majority of such cases. Only 1.7% of the whole sample showed an unexplained increase in serum creatinine, but none of these cases developed ESRD. The authors concluded that controlled nonmalignant essential hypertension did not lead to ESRD or clinically significant renal dysfunction. It has been stated that a myriad of other conditions could actually be the cause of ESRD attributed to essential hypertension in Caucasians Figure 125. Nevertheless, in African American patients, who show a special susceptibility to nephrosclerosis, it has been documented progression to ESRD26.
