Diastolic hypertension and chronic proteinuria

Abstract

1. 1. A high incidence of diastolic hypertension, several times above that anticipated in the age group, developed in a series of 623 young male subjects with prior chronic orthostatic and asymptomatic proteinuria. 2. 2. The incidence of diastolic hypertension paralleled the degree of renal damage indicated by proteinuria and other parameters of renal disease and functions. Individual clinical study indicated that hypertension in the great majority of these patients was nephrogenic. 3. 3. Chronic pyelonephritis was detectable with increasing frequency with progressing renal injury and hypertension. A direct causal relationship between renal infection and hypertension in these instances is probable. Renal infection may be initially present as inapparent chronic pyelonephritis or later superimposed upon various latent renal diseases and malformations, initially manifested by variable proteinuria. 4. 4. Unsuspected unilateral renal anomalies and obstructive lesions were discovered incidentally by routine excretory urography in approximately 15 per cent of these patients. Hypertension directly or indirectly induced by these lesions is considered potentially curable.