6442 HOW CAN IT BE NEPHROANGIOSCLEROSIS? HE´S BEING TREATED ONLY WITH ONE ANTIHYPERTENSIVE DRUG

Abstract Background and Aims Nephroangiosclerosis is a frequent renal disease due to chronic arterial hypertension and it is one of the main causes leading to renal replacement therapy. A minority of these patients have nephroangiosclerosis although they apparently have hypertension under control with minimal treatment. Objetives To describe the characteristics of this group of patients when compared to the rest of patients with histological diagnosis of nephroangiosclerosis. Method Observational, retrospective and descriptive study. Review of 67 patients with nephroangiosclerosis as the sole diagnosis in the renal biopsy (consecutive biopsies from 2010 to 2020). We divided the population in two different groups according to the number of prescribed antihypertensive drugs: Group 1 (0-1 antihypertensive drugs) vs Group 2 (≥2 antihypertensive drugs). Results Both groups had similar demographics and renal function/proteinuria. Both groups had the same adequate/inadequate blood pressure control, but group 1 had significantly less time of hypertension'evolution. The histological differences (although not statistically significant) are noteworthy: Group 1 had a higher percentage of global glomerulosclerosis, interstitial fibrosis and tubular atrophy than Group 2. In addition, after 3-years of follow-up, in Group 1 there were more patients requiring renal replacement therapy. We hypothesize that a factor that could explain these results could be the lower use of RASi (33.3% vs 73.9%, P = .003*) and a higher percentage of history of dyslipidemia in Group 1 (62.,5% vs 22.,2%, p=0,017*). Conclusion Patients with hypertension requiring a maximum of one drug for its control, presented histological results of more marked nephroangiosclerosis, than the group of patients with more than one drug, despite similar time of evolution and degree of blood pressure control. These findings could be related to a lower rate of RASi use. Our study reinforces the indication for RASi as a first-line hypertension treatment in this population. Table 1: Clinical data Group 1 (n=21) Group 2 (n=46) p-value Age (years) 60,7±12,4 62,4±11,1 0,410 Male sex (%) 61,9 73,9 0,319 Body mass index (Kg/m2) 27±4 28±6 0,630 Family history of hypertension (%) 12,5 30,4 0,063 Smoker (%) 28.6 46.5 0.245 Diabetes mellitus (%) 28,6 45,7 0,186 Dyslipemia (%) 62,5 22,2 0,017* Age at diagnosis of hypertension (years) 53±11 50±12 0,650 Time of evolution of hypertension (months) 92±91 140±80 0,035* Target blood