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To evaluate the current pattern of aetiology and outcome in malignant hypertension, we reviewed all medical records of patients presenting between 1979 and 1985 who fulfilled WHO criteria for malignant hypertension. There were 83 patients, 43 males (52%) and 40 females (48%). Primary malignant hypertension was diagnosed in 17 cases (20%) and secondary lesions in 66 cases (80%). Overall one year survival was 94%, and 5 year survival 75%, which is similar to recent reports. Initial serum creatinine was a prognostic indicator.

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Six patients with polycythemia vera and proteinuria are described. Three patients had histologically defined glomerulonephritis. It is proposed that there is an association between polycythemia vera and the development of glomerulonephritis. Possible pathogenetic mechanisms are discussed.