Vol 22, No 1 (2018)
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Published online: 2017-12-14

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The relationship between blood pressure changes and the efficacy of treatment in patients with primary glomerulonephritis with special regard to kidney size

Elżbieta Marcinkowska1, Jacek Manitius2
DOI: 10.5603/AH.a2017.0023
Arterial Hypertension 2018;22(1):16-28.

Abstract

Introduction. Blood pressure plays a modulating role in the progression of glomerulonephritis. Kidney size could also constitute a factor influencing the efficacy of treatment.

The study sought to determine renal length and the influence of blood pressure changes and renal length on the efficacy of treatment.

Material and methods. This study included 53 adult patients (25 female and 28 male), aged 17 to 63. At the beginning of the observation period, the following tests were performed: percutaneous renal biopsy, anthropometric measurements, renal length in abdominal ultrasound scan. At the beginning of the observation period and after 24 months the following tests were performed: SBP, DBP, MAP, PP, serum creatinine level, GFR MDRD, DPL. Absolute renal length (D) was related to anthropometric parameters and values of relative renal length D/H, D/BSA, D/BMI were calculated.

Results. D value ranged from 93.5 mm to 135.5 mm. Mean values of parameters were: D/H 0.67 ± 0.07 mm/cm, D/BSA 61.8 ± 8.7 mm/m2, D/BMI 4.67 ± 0.79 mm/kg/m2. No correlations were found of DPL changes and GFR MDRD changes with arterial pressure. A correlation was found between DPL changes and D. In patients whose DPL values decreased by at least 50%, mean values of D, D/H and D/BSA were higher. No correlations were found of GFR MDRD changes with D, D/H, D/BSA or D/BMI.

Conclusions. No influence of arterial blood pressure on the efficacy of treatment was discovered. Renal length is not a prognostic factor for changes in glomerular filtration rate; however, it can be a prognostic factor for proteinuria changes.

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