Bilateral nephrectomy as a rescue therapy for refractory hypertension in an end stage renal disease patient:  Brahmastra in hypertension management–A case report

Balagobi, B.; Niroshan, V.; Brammah, T.; BavanthanV,; Gowribahan, T.; Weerasinghe, N.

doi:10.1016/j.ijscr.2022.107566

Cited by 1 publication

(1 citation statement)

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“…When primary focal segmental glomerulosclerosis develops further, it can lead to renal insufficiency and hypertension. The mechanisms of primary focal segmental glomerulosclerosis causing hypertension mainly involve: (I) the activation of the reninangiotensin system leads to the increase of renin-angiotensin secretion, resulting in hypertension (11)(12)(13); and (II) water and sodium retention due to renal insufficiency causes excessive blood volume, which leads to hypertension (14)(15)(16). Malignant hypertension can also promote glomerular filtration rate decline, atrophy of renal tubules, and renal interstitial fibrosis, leading to the development of end-stage renal disease and eventually forming a vicious circle (17).…”

Section: Discussionmentioning

confidence: 99%

Effect of hypertension on the long-term prognosis of children with primary focal segmental glomerulosclerosis-a retrospective cohort study

Huang¹,

Peng²

2023

Transl Pediatr

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Background: Primary focal segmental glomerulosclerosis is a common clinicopathologic syndrome. More than 50% of the patients may have hypertension, which can further deteriorate the renal function of patients.However, the impact of hypertension on the development of end-stage renal disease in children with primary focal segmental glomerulosclerosis is still unclear. The end-stage renal disease greatly increases medical costs and mortality. Studying the related factors of end-stage renal disease is helpful to prevent and treat end-stage renal disease. This study aimed to explore the impact of hypertension on the long-term prognosis of children with primary focal segmental glomerulosclerosis. Methods:The data of 118 children with primary focal segmental glomerulosclerosis admitted to the Nursing Department of West China Second Hospital from January 2012 to January 2017 were retrospectively collected. The children were divided into a hypertension group (n=48) and a control group (n=70) according to whether they had hypertension. The children were followed up (by clinic visit and telephone interviews) for 5 years to compare the differences in the incidence of end-stage renal disease between the two groups.Results: Compared with the control group, the proportion of patients with severe renal tubulointerstitial damage in the hypertension group was significantly higher (18.75% vs. 5.71%, P=0.026). Moreover, the incidence of end-stage renal disease was markedly higher (33.33% vs. 5.71%, P<0.001). Both systolic and diastolic blood pressure had a certain value in predicting the development of end-stage renal disease in children with primary focal segmental glomerulosclerosis (P<0.001 and P=0.025, respectively), and the predictive value of systolic blood pressure was relatively higher. Multivariate logistic regression analysis showed that hypertension was risk factors for end-stage renal disease in children with primary focal segmental glomerulosclerosis (P=0.009, relative risk: 17.022, 95% CI: 2.045-141.723).Conclusions: Hypertension was a risk factor for poor long-term prognosis in children with primary focal segmental glomerulosclerosis. For primary focal segmental glomerulosclerosis children with hypertension, blood pressure should be actively controlled to prevent the development of end-stage renal disease.Moreover, due to the high incidence of end-stage renal disease, we should monitor the end-stage renal disease during follow-up.

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