Hypertensive nephropathy – A yet unsolved problem

IntroductionDespite increasingly more effective treatment methods of arterial hypertension (AH), there is a constant increase in the diagnosis of hypertensive nephropathy (HN). Diagnostic criteria of HN are not precisely defined.AimThe aim of this paper is to present literature reports and systematize current knowledge on HN.DiscussionAlthough HN is defined as histological lesions in renal arteries, arterioles and interstitium that occur due to long-term primary AH, rarely diagnosis of HN is made on the basis of renal biopsy. Nephrologists agree that high blood pressure values exacerbate all forms of chronic kidney disease (CKD), accelerating its progression to end stage renal disease. However, there is no evidence that mild and moderate AH may initiate kidney damage. Recent years’ discoveries of MYH9 and APOL1 gene polymorphism association with HN seem to confirm these doubts and prove that, at least in the African American population, HN may be a genetically determined disease.ConclusionsThe concept of primary AH being the cause of HN requires reconsideration. There is evidence suggesting that lesions considered as secondary to AH may indeed be a genetically determined disorder.