{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:34:34Z","timestamp":1791912874823,"version":"4.3.4"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,31]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Nephrosclerosis is one of the histopathological consequences of severe or malignant hypertension (MH), some of the pathophysiology of which has been extrapolated from essential polygenetic arterial hypertension. Despite our recent description of unsuspected ciliopathies with MH, causes of MH in young patients with severe renal impairment are poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>To refine and better describe the MH phenotype, we studied clinical and prognostic factors in young patients receiving a kidney biopsy following their first episode of MH. Patients were identified retrospectively and prospectively from eight centres over a 35-year period (1985\u20132020). Keywords were used to retrospectively enrol patients irrespective of lesions found on renal biopsy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 114 patients were included, 77 (67%) of whom were men, average age 34\u00a0years, 35% Caucasian and 34% African origin. An isolated clinical diagnosis of severe nephrosclerosis was suggested in only 52% of cases, with 24% primary glomerulopathies. Only 7% of patients had normal renal function at diagnosis, 25% required emergency dialysis and 21% were eventually transplanted. Mortality was 1% at the last follow-up. Independent prognostic factors significantly associated with renal prognosis (6-month dialysis) and predictive of end-stage renal disease were serum creatinine on admission {odds ratio [OR] 1.56 [95% confidence interval (CI) 1.34\u20131.96], P\u00a0&amp;lt;\u00a0.001} and renal fibrosis &amp;gt;30% [OR 10.70 (95% CI 1.53\u2013112.03), P\u00a0=\u00a0.03]. Astonishingly, the presence of any thrombotic microangiopathy lesion on renal biopsy was an independent, protective factor [OR 0.14 (95% CI 0.02\u20130.60), P\u00a0=\u00a0.01]. The histopathological hallmark of nephrosclerosis was found alone in only 52% of study patients, regardless of ethnicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This suggests that kidney biopsy might be beneficial in young patients with MH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfac324","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T15:14:53Z","timestamp":1670253293000},"page":"1848-1856","source":"Crossref","is-referenced-by-count":14,"title":["Nephrosclerosis in young patients with malignant hypertension"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1597-8127","authenticated-orcid":false,"given":"C\u00f4me","family":"Bureau","sequence":"first","affiliation":[{"name":"Assistance Publique \u2013 H\u00f4pitaux de Paris, Soins Intensifs N\u00e9phrologiques et Rein Aigu, APHP Sorbonne Universit\u00e9, H\u00f4pital Tenon , Paris , France"},{"name":"French Intensive Care Renal Network , Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Jamme","sequence":"additional","affiliation":[{"name":"French Intensive Care Renal Network , Marseille France"},{"name":"INSERM U1018, Centre de recherche en \u00e9pid\u00e9miologie et sant\u00e9 des populations, Equipe \u201cRein et C\u0153ur\u201d, Universit\u00e9 Paris Saclay , Villejuif , France"},{"name":"Ramsay G\u00e9n\u00e9rale de Sant\u00e9, R\u00e9animation polyvalente, H\u00f4pital priv\u00e9 de l'Ouest Parisien , Trappes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliet","family":"Schurder","sequence":"additional","affiliation":[{"name":"Assistance Publique \u2013 H\u00f4pitaux de Paris, N\u00e9phrologie, H\u00f4pital Europ\u00e9en Georges Pompidou , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-0372","authenticated-orcid":false,"given":"Micka\u00ebl","family":"Bobot","sequence":"additional","affiliation":[{"name":"French Intensive Care Renal Network , Marseille France"},{"name":"Centre de n\u00e9phrologie et transplantation r\u00e9nale, H\u00f4pital de la conception AP-HM Marseille , Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Robert","sequence":"additional","affiliation":[{"name":"French Intensive Care Renal Network , Marseille France"},{"name":"Centre de n\u00e9phrologie et transplantation r\u00e9nale, H\u00f4pital de la conception AP-HM Marseille , Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymeric","family":"Couturier","sequence":"additional","affiliation":[{"name":"Assistance Publique \u2013 H\u00f4pitaux de Paris, N\u00e9phrologie, H\u00f4pital Ambroise Par\u00e9 , Boulogne , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Karras","sequence":"additional","affiliation":[{"name":"Assistance Publique \u2013 H\u00f4pitaux de Paris, N\u00e9phrologie, H\u00f4pital Europ\u00e9en Georges Pompidou , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Halimi","sequence":"additional","affiliation":[{"name":"French Intensive Care Renal Network , Marseille France"},{"name":"Centre Hospitalier R\u00e9gional Universitaire de Tours, N\u00e9phrologie-Hypertension, Dialyses, Transplantation r\u00e9nale, H\u00f4pital Bretonneau, Tours, France, EA4245, Universit\u00e9 de Tours , Cardiovascular and Renal Clinical Trialists"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Bellenfant","sequence":"additional","affiliation":[{"name":"French Intensive Care Renal Network , Marseille France"},{"name":"Centre Hospitalier Intercommunal Andr\u00e9 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