Renal endpoints in hypertension trials.

A growing interest in the investigation of renal function has developed in recent years in big trials. This is justified by the high prevalence of nephrosclerosis as a cause of end-stage renal disease and the capacity of minor alterations of renal function to predict poor outcome for the patients. The finding of a small increase in serum creatinine values, a diminished estimated glomerular filtration rate, microalbuminuria and/or proteinuria, heralds a significant elevation in cardiovascular events and death as well as in total mortality. This paper describes the detection, prevalence and relevance of minor alterations in the stratification of cardiovascular risk in the hypertensive patient.