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Figure 1. A 41-year-old woman with blurred vision and dyspnea was found to have severe hypertension (blood pressure, 240/125 mm Hg in both arms) and grade IV hypertensive retinopathy. Laboratory studies revealed a hematocrit of 23 percent, a platelet count of 76,000 per cubic millimeter, a blood urea nitrogen concentration of 139 mg per deciliter (50 mmol per liter), and a serum creatinine concentration of 9.6 mg per deciliter (849 µmol per liter). Schistocytes were present in a blood smear. Urinalysis revealed proteinuria, hematuria, dysmorphic red cells, and renal tubular epithelial cell casts. Renal biopsy revealed chronic hypertensive injury, . . . [Full Text of this Article] |
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