Hypertension and renal dysfunction.

The various end-stage renal disease registries have documented a progressive and substantial increase of hypertension as a cause of renal failure. However, the relationship between essential hypertension and progressive renal disease is unclear. Black hypertensive patients, who are more prone to renal failure during their middle age, have a peculiar hypertensive nephropathy possibly requiring an aggressive antihypertensive therapy. Hypertension-associated progressive renal disease in the Caucasian population usually appears in the elderly and may be related to atheromatous renovascular disease. Only a few hypertensive patients have a true progressive hypertensive nephrosclerosis.