Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical and specific examination of 525 patients with special emphasis on ultrasonic, radionuclide and angiographic procedures, a captopril pharmaco-radiological test, radioimmunoassay of renin in the renal vein and vena cava inferior provided the diagnosis of vasorenal hypertension (VRH) in 65 of them (30 males, 35 females at the age of 18-60). Among etiological factors atherosclerosis, fibromuscular dysplasia, nephroptosis, renal artery aneurysm, aortic arteritis were involved in 40%, 24.6%, 16.9%, 12.3%, 6.2% of the cases, respectively. Chronic renal failure developed in 17% of VRH patients with the disease duration more than 3 years. Also, aspects of evaluation of cardiovascular function with invasive and noninvasive techniques in pre-, intra- and postoperative periods, indications to VRH, basic operative procedures are reviewed. According to WHO criteria, a complete response was obtained in 21 (35.6%), a partial response in 34 (57.6%) patients, no response was registered in 1 (1.7%) case.
 ...
PMID:[The diagnosis of vasorenal arterial hypertension]. 801 5

Cardiac events are a major cause of death in dialysed patients. This is due, at least in part, to the high prevalence of atherosclerotic coronary heart disease. To a large extent, however, coronary lesions are acquired in the predialytic phase of chronic renal failure. The susceptibility of the heart to ischaemia is modulated by a number of factors, e.g. microvascular abnormalities, increased cardiac pulsatile workload, disturbed cardiac glucose metabolism, imbalanced autonomic innervation. The paradoxical result of there being no relationship of cardiac death in dialysis patients to blood pressure may be explained by confounding factors. Intradialytic hypotension appears to be an independent risk factor. The dialysis patient is exposed to hypertension and dyslipidaemia, two potent risk factors of atherosclerosis. Although no definite information is available, it is conceivable that factors related to dialysis procedures may also influence early or late events in atherogenesis. Such potential factors include oxidative modification of lipids, modulation of insulin resistance or glucose metabolism by non-insulin-dependent pathways, expression of adhesion molecules and activation of potential effector cells in atherogenesis, particularly monocytes and platelets, changes of synthesis and/or response to endothelin and nitroxide (EDRF), and possibly also accelerated formation of advanced plaques by hyperphosphataemia and/or hyperparathyroidism. Such proatherogenic mechanisms must be balanced against factors potentially protecting against atherogenesis; these comprise altered arachidonic acid metabolism (increased prostacyclin and decreased thromboxane synthesis), impaired platelet aggregation, antiatherosclerotic effects of heparin, and diminished concentrations of 1,25(OH)2D3, i.e. of a proatherogenic compound.
 ...
PMID:Atherogenesis and cardiac death: are they related to dialysis procedure and biocompatibility? 806 10

Cerebrovascular accident (CVA) is an important predictor of survival in patients with chronic renal failure (CRF). Although serum lipoprotein (a) [Lp(a)] is an independent risk factor for atherosclerosis in the general population and Lp(a) levels are increased in patients with CRF, the relationship between increased Lp(a) and CVA has not been clarified in patients with CRF. We therefore determined the association between serum Lp(a) levels and the risk of CVA in a retrospective study of 105 patients with CRF. Lp(a) was measured by ELISA in 31 patients with CVA and 74 patients without CVA. The median Lp(a) concentration of the patients with CVA was significantly higher than that of patients without CVA (38 vs 23 mg/dl: p < 0.001). Logistic regression analysis determined that elevated serum Lp(a) concentration (relative risk ratio: 1.041, p < 0.005), hypertension (relative risk ratio: 9.747, p < 0.05) and smoking (relative risk ratio: 4.554, p < 0.05) were risk factors for CVA. In contrast, serum total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, gender underlying condition of renal disease and duration of hemodialysis were not associated with an increased risk of CVA. These results suggest that Lp(a) is a risk factor for clinical events attributable to CVA in patients with CRF.
 ...
PMID:[Lipoprotein (a) is a risk factor for cerebrovascular accident in patients with chronic renal failure]. 807 23

Lipoprotein(a) [Lp(a)] has recently been characterized as a genetically determined risk factor for atherosclerosis and thrombosis. Normally, Lp(a) serum levels are closely related to the apo(a) phenotype. We studied Lp(a) serum levels and apo(a) phenotypes in 136 young subjects, aged 0.8-24.7 y, including patients with glomerular disease and normal renal function (n = 28), patients with chronic renal failure (n = 20), patients treated by hemodialysis (n = 10), peritoneal dialysis (n = 16), and renal transplantation (n = 23), and in controls (n = 39). Of all, 21 patients had proteinuria in the nephrotic range. The distribution of Lp(a) levels in normal subjects was skewed to the left with 97% having levels below 300 mg/L. A subpopulation with increased Lp(a) levels (13-42%) could be detected in all groups with renal disease, and increased mean serum Lp(a) levels were found in patients with nephrotic range proteinuria, in patients with chronic renal failure, and in patients on peritoneal dialysis. Serum Lp(a) levels were not correlated with age, gender, type of renal disease, renal function or severity of proteinuria, but were correlated with the apo(a) phenotype. For a given phenotype, Lp(a) levels tended to be higher in patients than in controls. We conclude that increased Lp(a) serum levels are frequently found in young patients with chronic renal disease, possibly predisposing them to an increased risk for atherosclerosis and thrombosis.
 ...
PMID:Lipoprotein(a) serum levels and apolipoprotein(a) phenotypes in children with chronic renal disease. 810 91

Nitric oxide is widely distributed in the body. It has an important role in the regulation of the circulation and as yet, ill-defined roles in nervous and immune systems. It is derived from L-arginine from a reaction catalysed by a constitutive intracellular enzyme, nitric oxide synthase. It is recognised as the endogenous nitrovasodilator whose action is mimicked by all exogenous nitrovasodilators. After production in the vascular endothelial cell, it diffuses to the smooth muscle cell where it activates the enzyme guanylate cyclase which leads to an increase in cyclic GMP and thence to muscle relaxation. The duration of its action is brief, a few seconds. Disorders of NO metabolism underlie many disease states including endotoxic shock in which prolonged production of nitric oxide may be induced by cytokines. Deficiencies in endogenous production may account for hypertension in various disease states including atherosclerosis and chronic renal failure. NO therapy been used experimentally to successfully treat idiopathic pulmonary hypertension and pulmonary hypertension associated with cardiac and respiratory diseases. However, the long-term benefits have yet to be studied. Administration of NO requires the use of a device to monitor the concentrations of both NO and of NO2. The latter is a noxious agent and a time-related product of the reaction between NO and O2 and is a possible contaminant of preparations of NO. Precautions must be taken to prevent contamination of the work-place atmosphere with NO and NO2. These include gas scavenging and the use of a leak-free system for spontaneous and mechanical ventilation. Using NO in its gaseous form, clinicians have at long last been provided with the means to treat pulmonary hypertension without adversely causing systemic hypotension. The therapy is most suited to short-term use in mechanically ventilated patients. Safe practical long-term NO therapy must await the development of agents which release NO from aerosol preparations.
 ...
PMID:The role of nitric oxide (formerly endothelium-derived relaxing factor-EDRF) in vasodilatation and vasodilator therapy. 812 32

Renal transplantation is the preferred treatment modality for patients with ESRD who are good surgical risks and able to comply with chronic immunosuppressive medications. Clinical transplantation has advanced significantly, with most transplant centers reporting 1-yr renal allograft survival rates of better than 80%. Nevertheless, rejection and a progressive loss of allografts over time continue to occur. The immunosuppressive agents currently used may lead to the development of life-threatening infections, malignancies, and advanced atherosclerosis as a consequence of some of their side effects. This review examines the mechanisms involved in allograft rejection as currently understood. The recent knowledge into the mechanism of action of cyclosporine, FK506, and rapamycin on T cell activation is presented. Information recently available on some of the established therapies such as steroids, antimetabolites and monoclonal antibodies as well as the newer agents is also discussed. The interaction between clinical transplantation and basic research in immunology continues to result in exciting advances in both fields.
 ...
PMID:Prevention and treatment of renal allograft rejection: new therapeutic approaches and new insights into established therapies. 813 Mar 52

Chronic renal failure (CRF) in nondiabetics is associated with a number of lipoprotein abnormalities that place these patients at high risk for atherosclerosis. This study compared the lipoprotein composition of nondiabetic controls (n = 68) with that of patients with insulin-dependent diabetes mellitus ([IDDM] n = 13) and of patients with IDDM and CRF ([IDDM + CRF] n = 74). Six lipoprotein subfractions (very-low-density lipoprotein [VLDL], intermediate-density lipoprotein [IDL], low-density lipoprotein [LDL], high-density lipoprotein-light [HDL-L], HDL-medium [HDL-M], and HDL-dense [HDL-D]) were isolated by rapid gradient ultracentrifugation using a fixed-angle rotor. The apolipoprotein (by reverse-phase high-performance liquid chromatography [HPLC]) and lipid (by enzymatic assays) composition of each subfraction was determined. The only abnormalities found in IDDM patients were increases in IDL and HDL-L triglyceride (TG) levels and an increase in the HDL-L free cholesterol (FC) level. The IDDM + CRF group had multiple abnormalities including (1) elevated TG, apolipoprotein (apo) C-II, and apo C-III levels in all lipid subfractions; (2) elevated VLDL and IDL apo B, TG, FC, cholesterol ester (CE), and phospholipid (PL) levels (with an increased CE/TG ratio in VLDL only); (3) decreased HDL-M apo A-I, apo A-II, CE, and PL levels, but an increased HDL-D apo A-I level; and (4) decreased lecithin:cholesterol acyltransferase (LCAT) activity. Twenty-five of the IDDM + CRF patients underwent combined pancreas and kidney (P + K) transplantation, and 12 patients received only a kidney transplant. Lipoprotein composition was determined at 3, 6, and 12 months posttransplant. Both types of transplantation resulted in similar alterations in lipoprotein composition, even though there was essential normalization of blood glucose levels in most of the patients who received a pancreas transplant (hemoglobin A1C [HbA1C], 9.1% +/- 1.1% v 5.7% +/- 0.3% at 12 months, P < .01). These posttransplant changes included (1) no improvement in the elevated TG level in any lipid subfraction even though there was some reduction in apo C-III levels in VLDL; (2) reductions in levels of VLDL and IDL apo B but increases in LDL apo B; (3) increases in HDL apo C-III and FC concentrations despite an increase in LCAT activity; and (4) increases in apo A-I levels in HDL-L and HDL-M. The addition of a pancreas to a kidney transplant had no obvious impact on the lipoproteins.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Lipoprotein composition in insulin-dependent diabetes mellitus with chronic renal failure: effect of kidney and pancreas transplantation. 813 82

After having highlighted the main possible ocular abnormalities in patients affected by chronic renal failure treated with hemodialysis, we describe our observations in 12 hemodialyzed patients. Evaluation of the examined fluoroangiographic patterns was interesting because, in seven patients (58.4%), focal choroidal perfusion defects were found, mainly localized in the posterior pole and nasal portion. Similar fluoroangiographic findings have been observed in patients with hypertension and diabetes mellitus and anatomic and histologic studies have proved the existence of diabetic choroidopathy; therefore, we suggest that the onset of choroidopathy in hemodialyzed patients depends on an early arteriolar atherosclerosis of the choroidal membrane, probably secondary to chronic renal failure rather than to extracorporeal dialysis.
 ...
PMID:Fluoroangiographic findings in hemodialyzed patients. 830 89

A retrospective multi-institutional study was performed to document and characterize the arterial vascular disease in the hypogastric-cavernous arterial bed and/or veno-occlusive dysfunction of the corpora cavernosa in patients with end stage renal disease. We evaluated 20 impotent patients (mean age 40 +/- 9 years) with chronic renal failure using pharmaco-cavernosometry and pharmacocavernosography (4 also underwent pharmaco-arteriography). Patients were divided into groups based on the treatment (14 with renal transplantation and 6 with hemodialysis or peritoneal dialysis), as well as by history of vascular risk factors (16 with and 4 without risk factors). Of the patients 19 revealed abnormal intracavernous pressure responses to repeated intracavenous injections of vasoactive agents implying vascular disease of the penis. Cavernous artery occlusive disease was found in 78% of the patients. All patients who underwent arteriography had diffuse atherosclerotic disease of the distal penile arteries. Corporeal veno-occlusive dysfunction was found in 90% of the patients, of whom 60% had diffuse pan-cavernous leakage involving the dorsal, cavernous and crural veins, glans penis and corpus spongiosum. This renal failure-associated vascular disease of the penis was found to occur independently of the presence of known systemic atherosclerotic vascular risk factors. Patients who underwent early treatment of the uremia by renal transplantation had vasculogenic impotence only in the case of rejection of the renal transplant, suggesting that early renal transplantation may delay or prevent the development of the penile vasculopathy. The most likely pathophysiology of the vascular impairment includes renal failure-associated atherosclerosis, and renal failure-associated hypoxia changes of the contractile (smooth muscle) and structural (collagen/elastin) components of the erectile tissue. Strategies for future research and clinical therapies are suggested.
 ...
PMID:Impotence and chronic renal failure: a study of the hemodynamic pathophysiology. 830 70

1. Selenium status was investigated in patients with chronic renal failure, with special regard to its relations to the dialysis treatments, dietary habits and clinical signs of atherosclerosis. 2. Serum selenium concentration and platelet glutathione peroxidase activity were measured in 45 patients with chronic renal failure subdivided into three groups according to the type of treatment: 15 non-dialysed, 15 on haemodialysis, 15 on continuous ambulatory peritoneal dialysis. A 7-day diet history was carried out in all patients. Seventeen of the patients with chronic renal failure had clinically overt cardiovascular disease. Forty-five age-matched healthy subjects were considered as controls. 3. Both serum selenium concentration and platelet glutathione peroxidase were significantly reduced in all patients with chronic renal failure compared with control subjects; a direct and significant correlation was found between the two parameters. No differences in selenium status were observed among the non-dialysed, haemodialysis and continuous ambulatory peritoneal dialysis groups. No correlation between total calorie or protein intakes and selenium indices were observed. The chronic renal failure patients with cardiovascular complications showed a further significant reduction in both serum selenium concentration and platelet glutathione peroxidase activity as compared with the patients without cardiovascular complications; these two groups were similar with respect to the other well-known cardiovascular risk factors (age, smoking, plasma lipids, hypertension, body mass index). 4. It is concluded that a low selenium concentration is present in chronic renal failure, which is independent of dialysis and is accompanied by biological repercussion in terms of reduced platelet glutathione peroxidase activity.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Low platelet glutathione peroxidase activity and serum selenium concentration in patients with chronic renal failure: relations to dialysis treatments, diet and cardiovascular complications. 833 7


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>