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Nephroangiosclerosis not related to hypertension: A matter to resolve in the era of precision medicine

Journal of Human Hypertension volume 37, pages 931–935 (2023)Cite this article

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Abstract

Nephroangiosclerosis (NAS) associated with hypertension continues to be one of the most causes of end stage renal diseases in Europe, but it is still poorly studied. The prevalence of NAS shows a large variability due to the difference among different countries regarding clinical presentations and the indication to perform renal biopsy. The study aimed to investigate the prevalence in biopsy-proven NAS patients and the association with hypertension and/or glomerulonephritis (GN). We included all patients referred for native kidney biopsy between 2003–2021 at Policlinic Umberto I of Rome. From 837 patients who underwent renal biopsy NAS was diagnosed in 80 (10.5%) patients. Serum creatinine was significantly higher in NAS [2.07 mg/dl (IQR 1.13–5.2) vs 1.1 mg/dl (IQR 0.8–2.1), p < 0.001] compared to patients without NAS. Hypertension was present in 45% of patients with NAS. Proteinuria was significantly higher in patients with mild-moderate NAS compared to patients with severe NAS [2.6 g/die (IQR 1–5) vs 1.5 g/die (IQR 0.86–2.3), p < 0.05]. We did not find any significant differences, including histological features, between NAS patients with hypertension and NAS patients without hypertension (p > 0.05). IgA nephropathy, focal segmental glomerulosclerosis and membranous nephropathy were the most frequent GN associated. In conclusion no specific histological features are reported in NAS with and without hypertension. More information on the phenotype, clinical presentation and markers are needed to improve histological and clinical diagnostics.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy

    Antonietta Gigante, Silvia Lai, Chiara Pellicano, Oriana De Marco, Edoardo Rosato, Maurizio Muscaritoli & Rosario Cianci

  2. Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Sapienza, Italy

    Konstantinos Giannakakis & Giulia D’Amati

  3. Department of Clinical Medicine, Public Health, Life and Environmental Sciences, Internal Medicine and Nephrology Unit, ESH Excellence Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L’Aquila, L’Aquila, Italy

    Claudio Ferri

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  1. Antonietta Gigante
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Contributions

AG analysis and interpretation of data, drafting of the paper, final approval of the paper submitted; SL Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work, final approval of the paper submitted; CP Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work, final approval of the paper submitted; ODM Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work, final approval of the paper submitted; ER Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work, final approval of the paper submitted; KG Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work, final approval of the paper submitted; GD’A Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work, final approval of the paper submitted; MM Substantial contributions to data interpretation. Substantial contributions to the critical revision of the work, final approval of the paper submitted; CF analysis and interpretation of data, drafting of the paper, final approval of the paper submitted; RC analysis and interpretation of data, drafting of the paper, final approval of the paper submitted.

Corresponding author

Correspondence to Rosario Cianci.

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The authors declare no competing interests.

Ethical approval

The study was conducted in accordance with the protocol, good clinical practice principles and the Declaration of Helsinki statements. The informed consents were collected and the study was approved by the local Ethics Committee in 2021.

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Gigante, A., Lai, S., Pellicano, C. et al. Nephroangiosclerosis not related to hypertension: A matter to resolve in the era of precision medicine. J Hum Hypertens 37, 931–935 (2023). https://doi.org/10.1038/s41371-022-00796-5

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