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Objective To describe recovery of renal function (RC) in Black South African patients with primary malignant hypertension (MHT) and end-stage renal failure, according to the type of dialysis provided. Design A retrospective analysis of the records of 31 patients with MHT. Setting A university-based, large tertiary-care hospital and its community-based satellite continuous ambulatory peritoneal dialysis (CAPD) clinics. Patients Only patients with renal failure caused by MHT and who were on dialysis between January 1997 and June 2000. There were 11 patients on peritoneal dialysis (PD) that regained renal function; 11 patients on hemodialysis (HD), none of whom recovered renal function; and 9 patients on PD who did not recover renal function during the same time period. Outcome Measures The groups were investigated for variables that might predict RC. Results Peritoneal dialysis compared with HD was highly significant as an indicator of RC ( p < 0.0001), with 60% of patients on PD regaining renal function, versus 0% on HD. Median time to recovery was 300 (150 – 365) days. There was no significant difference in decline of mean arterial pressure (MAP) between the groups; MAP declined significantly in all groups ( p = 0.000 02). All groups received similar drug therapy. In the RC group, initial MAP, kidney size, and urine output tended to be higher and creatinine lower ( p = not significant). Dialysis adequacy was similar in the different groups. Conclusions This retrospective study suggests there may be benefit from PD as the primary form of dialysis when patients have MHT as a cause of their renal failure. Possible predictors of RC include blood pressure control, initial MAP, initial serum creatinine, initial urine output, and kidney size. Time should be allowed for RC before transplantation is undertaken. Prospective studies are needed to confirm the benefit of CAPD in patients with MHT.

The literature suggests that there is a geographical, sociodemographic and temporal variation in histological patterns of renal disease, but data from African countries are fairly limited. [1-3] In South Africa (SA), chronic kidney disease (CKD) more than doubled from 1990 to 2010, [4] with the increase mainly attributed to hypertension and glomerular diseases. [5,6] Chris Hani Baragwanath Academic Hospital (CHBAH) serves a predominantly black population of >3.6 million people from Soweto (an urban 'township' in Gauteng Province, SA) and the surrounding areas, [7] and is one of the main referral centres for patients with renal disease. The community served by the hospital has a history of racial segregation, poverty and social inequalities. [8] No recent long-term data for the renal patient population of CHBAH have been published. Objectives To contribute to the knowledge regarding patterns and clinical presentation of renal disease at CHBAH and compare it with data available for other areas in SA and other countries. Methods A retrospective review was conducted of all renal histopathology reports from 1 January 1982 to 31 December 2011 for patients biopsied in the CHBAH adult renal unit. Renal biopsy remains the most precise method for making a definitive diagnosis of renal disease and predicting the likely clinical course, and guides further investigations and management of patients. [9,10] Our objectives were to describe the histopathological patterns of renal disease and to identify clinical pathological relationships between patient demographics, clinical presentations and histopathological diagnoses. We also compared patterns of renal disease between patients who were HIV-positive and those who were HIV-negative. Data gathered included the demographic profile (age, gender, ethnicity), results of haematological and urine investigations, indication for biopsy and histopathological diagnosis for each patient. Ethics approval was obtained from the Human Research Ethics Committee of the University of the Witwatersrand (ref. no. M120874). Native renal biopsy (one in which the patient's own, as opposed to transplanted, kidneys are biopsied) reports of male and female patients This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Background: The prevalence of chronic kidney disease is on the rise. Our objective is to describe two programs to improve the awareness and management of hypertension, renal disease, and diabetes in remote Australian Aboriginal and urban and periurban South African communities. We focus on how the Australian Aboriginal and South African Chronic Disease Outreach Programs have worked together. Methods: The establishment of prevention programs in developing countries is a challenge. The paper evaluates these challenges, including accessing international aid. The programs advocate that regular integrated checks for chronic disease and their risk factors are essential elements of regular adult health care. Programs should be run by primary health workers, following algorithms for testing and treatment, and a backup provided by nurse coordinators. Constant evaluation is essential to develop community health profiles and adapt program structure. Results: Both programs are discussed, including how they are organized to deliver preventative and treatment strategies. The challenges and adaptations required are outlined. Conclusions: It is the aim of the international kidney commu- nity to prevent chronic kidney disease. The South African and Australian groups highlight the need for a systematic and sustained approach to the management of chronic diseases to achieve this goal.