Hypertension, glomerular hypertrophy and nephrosclerosis: The effect of race

Hughson, Michael D., Puelles, Victor G., Hoy, Wendy E., Douglas-Denton, Rebecca N., Mott, Susan A. and Bertram, John F. (2014) Hypertension, glomerular hypertrophy and nephrosclerosis: The effect of race. Nephrology Dialysis Transplantation, 29 7: 1399-1409. doi:10.1093/ndt/gft480

Author Hughson, Michael D.
Puelles, Victor G.
Hoy, Wendy E.
Douglas-Denton, Rebecca N.
Mott, Susan A.
Bertram, John F.
Title Hypertension, glomerular hypertrophy and nephrosclerosis: The effect of race
Journal name Nephrology Dialysis Transplantation   Check publisher's open access policy
ISSN 0931-0509
Publication date 2014
Year available 2014
Sub-type Article (original research)
DOI 10.1093/ndt/gft480
Open Access Status
Volume 29
Issue 7
Start page 1399
End page 1409
Total pages 11
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2015
Language eng
Subject 2727 Nephrology
2747 Transplantation
Abstract BackgroundAfrican Americans have more severe hypertensive nephrosclerosis than white Americans, possibly at similar levels of blood pressure. Glomerular volume is increased in African Americans relative to whites, but it is uncertain how this relates to nephrosclerosis and whether it contributes to or compensates for glomerulosclerosis. MethodsStereological disector/fractionator estimates of glomerular number (Nglom) and average glomerular volume (Vglom) were obtained on autopsy kidneys of 171 African Americans and 131 whites. Eighty-eight African Americans and 49 whites were identified as hypertensive. Nephrosclerosis was measured morphometrically as the percentage of glomerulosclerosis, proportion of cortical fibrosis and interlobular artery intimal thickness, and analyzed with Vglom by age, race, gender, body mass index (BMI) and blood pressure. ResultsAfrican Americans were more frequently hypertensive (58.5%) than whites (35.8%) and when hypertensive had higher levels of blood pressure (P = 0.02). Nglom was significantly lower in hypertensive compared with non-hypertensive subjects among white women (P = 0.02) but not white males (P = 0.34) or African American females (P = 0.10) or males (P = 0.41). For each race and gender, glomerulosclerosis, cortical fibrosis and arterial intimal thickening were statistically correlated with age (P < 0.001) and hypertension (P < 0.001) and increased Vglom with hypertension (P < 0.001) and BMI (P < 0.001). In multivariate analysis, African American race was associated with increased Vglom (P = 0.01) and arterial intimal thickening (P < 0.01), while interactions between race and blood pressure indicated that the severity of nephrosclerosis including increased Vglom was linked most directly to hypertension without significant contributions from race. The hypertension-Associated enlargement of Vglom was present with mild degrees of glomerulosclerosis and changed little as the severity of glomerulosclerosis increased. ConclusionsGlomerular hypertrophy was identified as an integral feature of hypertensive nephropathy and appeared to precede rather than compensate for glomerulosclerosis. An effect of race on Vglom and arterial intimal thickening seemed to be related to the more frequent and more severe hypertension among African Americans.
Keyword Gender
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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