Hypertension in adults with idiopathic glomerulonephritis and normal serum creatinine. A report from the MRC Glomerulonephritis Registry

The Medical Research Council's Glomerulonephritis Registry wasused to determine the prevalence and clinical characteristicsof hypertension occurring in patients with idiopathic glomerulonephritis(GN) and normal serum creatinine (males <120µmol/l,females <100µmol/l). The hypertension prevalence ratewas 23.0% in 1221 such patients, increased significantly withage, and within each age group was greater in males than infemales. These patterns closely mirror those seen for hypertensionin the United Kingdom general population. However, the hypertension prevalence rates in the GN patientssignificantly exceeded those seen in the corresponding age/sexbands in the general UK population and varied considerably betweenGN subtypes; thus hypertension in patients with GN and ‘nearnormal’ renal function is not solely due to essentialhypertension. Logistic regression analysis demonstrated thatin addition to increasing age, the presence of hypertensionwas significantly associated with increased serum creatinine,even in these patients with serum creatinines within the normalrange. One possible explanation for these findings may be that peoplewith an inherited tendency to essential hypertension may alsobe more prone to hypertension if they develop GN. Our data suggeststhat this early hypertension is closely associated with mildimpairment of GFR, occurring within the accepted normal rangefor serum creatinine.