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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With increasing age, the thoracic aorta shows progressive fibroplastic intimal thickening, which is thought to be pre-atheromatous. A similar progressive intimal thickening in the renal cortical arteries is the distinguishing feature of the nephrosclerosis which underlies essential hypertension. Therefore, the earliest detectable youthful precursors of atherosclerosis and hypertension show strong morphological resemblances to each other. In this study, close statistical associations have been shown between the two types of arterial intimal fibroplasia. Both conditions show similar sigmoid growth curves from ages 6 to 70 years, thereby generating correlations across age groups of r = 0.99 in New Orleans and r = 0.95 in Mexico City. Specimens gathered in New Orleans were found to have about 1.4 times greater arterial intimal thickening than specimens from Mexico City, and this excess was seen at all ages in both the aortas and the renal cortical arteries. It seems likely that intimal fibroplasia of arteries is reflecting similar biological principles at all levels of the vascular tree. Whatever etiological factors vary between New Orleans and Mexico City, those factors appear to act directly at a tissue level to promote the early precursors of atherosclerosis and of the nephrosclerosis that underlies hypertension.
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PMID:Nephrosclerosis and aortic atherosclerosis from age 6 to 70 years in the United States and Mexico. 160 8

Cardiovascular disease is the third most common cause of death in Tshepong Hospital in the western Transvaal, and the most common cause of death in patients older than 35 years. A prospective study was undertaken which included limited necropsies in 90 of the 167 cardiovascular disease deaths over 1 year. A reliable mortality pattern for cardiovascular deaths is described. Additionally, attention is paid to co-existing conditions. Conditions relating to cardiovascular disease, such as hypertension, benign hypertensive nephrosclerosis, atherosclerosis and obesity, were also evaluated. Cerebrovascular conditions were found in 32% of cardiovascular deaths. Intracerebral haemorrhage was found in 50% and cerebral infarction in 29% of cases. Fifty-seven per cent of cardiovascular deaths were due to cardiac conditions, the most common being pulmonary hypertension (31%), dilated cardiomyopathy and chronic rheumatic valvular disease (17% each) and hypertensive heart disease (14%). Forty-nine per cent of subjects were hypertensive, while 40% exhibited benign nephrosclerosis and only 3% of the examined vessels had signs of severe atherosclerosis. Tuberculosis was present in 13% of cases. The clinical diagnosis was the same as the final necropsy diagnosis in 38% of cases. These results emphasise the importance of performing necropsies to obtain reliable mortality statistics.
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PMID:Cardiovascular causes of death at Tshepong Hospital in 1 year, 1989-1990. A necropsy study. 173 52

150 patients dying from renal cell carcinoma are studied in order to reveal the background disease, incidence and character of the nephrosclerosis and the possible morphogenetic link between nephrosclerosis and carcinoma. Renal cell carcinoma is found to develop in 82.7% of cases in the kidneys with signs of nephrosclerosis. The diffuse nephrosclerosis developing in connection with the hypertension disease, atherosclerosis, diabetes mellitus, chronic pyelonephritis, nephrolithiasis is the most important. Proliferation of the canaliculi epithelium with the appearance of undifferentiated cells are regularly found in the nephrosclerotic areas. The disturbance of the epithelium differentiation is followed by the development of dysplasia the phenotypical variants of which are similar to those of renal cell carcinoma. Adenomas are found in 11.3% of cases of renal cell carcinoma which may originate from the adenomas developing against the background of nephrosclerosis.
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PMID:[Background and precancerous processes in renal cell carcinoma]. 280 41

The aspect of nephrosclerosis reflected by fibrous intimal thickening of small arteries (arteriosclerosis) was measured by a newly introduced morphometric procedure in 154 autopsies of Japanese-American men in Honolulu. These men were subjects of the Honolulu Heart Program and had previously been assessed for blood pressure and other clinical characteristics in a prospective study. In periodic acid-Schiff (PAS)-stained sections of renal cortex, measurements were made of interlobular artery diameters and intimal thicknesses. Vessels of outer diameter 80 to 130 microns and 160 to 300 microns were examined separately and are called the "remote" and "close" levels of the interlobular arteries, respectively, defined in relation to the heart. Nephrosclerosis thus quantified, together with age, could be used to predict the levels of blood pressure (BP) to be found in retrospective review of past records. The mathematical function obtained in a former study to make these predictions was found to predict the observed levels of blood pressure to an acceptable degree in the groupings that involved 92% of the subjects. Verification of that formerly obtained predictive function is now claimed. Correlation coefficients relating BP to close and remote measures were about of equal magnitude (r = 0.34 and 0.40, respectively). Subjects with cardiovascular-renal causes of death differed in both nephrosclerosis and blood pressure from subjects whose cause of death was unrelated to cardiovascular-renal diseases; the two factors taken together each contributed significantly to the cause of death difference. Correlations between nephrosclerosis and aortic atherosclerosis were stronger than could be explained solely by a linkage to observed values of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Blood pressure, nephrosclerosis, and age autopsy findings from the Honolulu Heart Program. 306 80

Kidneys from 90 individuals who had died from atherosclerosis, hypertensive disease, or chronic glomerulonephritis were examined following early autopsies. The nephron epithelium and the endothelium of peritubular capillaries were studied for activities and distribution patterns of NADPH2 dehydrogenase, lactate dehydrogenase, succinate dehydrogenase, and acid and alkaline phosphatases, for relative capillary and connective tissue volumes, and for lymphocyte, monocyte, and plasma cell numbers. A mathematical analysis of the histochemical and morphometric data provided information on the nature of changes in the renal microcirculatory bed and on the roles of free stromal cells in various forms of nephrosclerosis as well as on the zonal distribution of the parameters studied. Intercellular and vascular-cellular links were found to be weakest in the most advanced stage of chronic glomerulonephritis involving reduction of peritubular capillaries. In cardiovascular disorders, the morphofunctional characteristics of the microcirculatory bed and of its volume showed reciprocal changes, probably of a compensatory character.
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PMID:[Interrelation of changes in the epithelium of kidney tubules and interstitium in nephrosclerosis based on morphometric and histochemical data]. 366 62

An observation in human autopsy material showing a statistically close relationship between complicated atherosclerosis of the aorta, at or above the renal artery take-off, and nephrosclerosis of usual type (i.e. the "granular kidney" of essential hypertension) led to a study of platelet aggregates as a cause of renal lesions. The renal cortical surface is peculiarly sensitive to ischemic damage. When an embolic source, which sheds repeatedly, was placed in the thoracic aorta of rabbits, they became hypertensive. The hypertension persisted for six months, at which time the kidneys showed nephrosclerosis characterized by surface cortical lesions consisting of shrunken glomeruli and atrophical tubules, subtended by arterioles whose intimas showed fibrous thickening. It is suggested that the renal component of the hypertension so induced is transitory, serving as a trigger mechanism for sustained hypertension.
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PMID:Hypertension and nephrosclerosis: a reappraisal and a new theory of renal ischemia. 602 68

Two cases of spontaneous atheromatous embolization associated with unusual complications are presented. One is an 85-year-old man who developed an acute abdomen and underwent a surgical resection of totally infarcted left-sided colon. Histologically, multiple acute atheromatous emboli were found occluding the serosal and pericolic mesenteric arteries causing transmural necrosis of the involved portion of bowel. The other is an 80-year-old woman who had had a coronary heart disease, hypertension, and renal insufficiency, and terminally developed a rapid deterioration of renal function and melena. Postmortem examination showed a severely, ulcerated, aortic atherosclerosis and widespread, recurrent, atheromatous emboli in many abdominal organs with the resultant severe nephrosclerosis, gastrointestinal mucosal hemorrhagic necrosis, and multiple infarcts in the pancreas and spleen. In addition, there was focal cortical necrosis of the kidneys accompanied with glomerular capillary fibrin thrombi indicating disseminated intravascular coagulation (DIC). These findings seen in the present two cases were briefly discussed in light of the previous pertinent literature.
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PMID:Atheromatous embolization. Report of two cases with unusual complications. 650 92

Report of necropsy findings of a 17 years old girl with a progeria syndrome. There was a high degree of generalized atherosclerosis, involving the visceral arteries, chiefly those to the kidneys. The patient died of nephrosclerosis with uraemia. The aetiology of progeria syndrome remains obscure, single findings (lipoprotein- and amino-acid metabolism) may be understood as an inborn error of metabolism.
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PMID:[Morphologic contribution to a progeria syndrome (Hutchinson-Gilford) (author's transl)]. 744 1

Transplantation of kidneys from older donors is being advocated to expand the organ donor pool. However, the prevalence of atherosclerosis and age-induced renal structural alterations account for the variable function of allografts procured from these older donors. Pretransplant biopsies are sometimes used to evaluate kidneys from older donors, but to date there are no defined criteria correlating the extent of structural alterations in these kidneys to subsequent function. We investigated the effect of glomerulosclerosis, a marker for nephrosclerosis, on graft outcome. Sixty-five baseline biopsies of kidney allografts were retrospectively analyzed to identify a referent point of glomerulosclerosis that correlated with inferior graft outcome. Age and death from nontraumatic cerebrovascular injuries were the main correlates for donor glomerulosclerosis (P < 0.001). Allografts with poor function at 6 months defined as serum creatinine > 2.5 mg/dl (n = 13) or nephrectomy (n = 4) had a mean of 20% glomerulosclerosis at the time of implantation compared with only 2% sclerosis in allografts with good function (P < 0.05). Delayed graft function occurred in 22% and 33% of recipients with no glomerulosclerosis and those with less than 20% glomerulosclerosis, respectively. In contrast, patients receiving kidneys with > 20% sclerosis had an 87% incidence of delayed function (P < 0.05). Moreover, graft loss occurred in 7% of recipients of kidneys with less than 20% sclerosis and in 38% of recipients with > 20% sclerosis (P < 0.04). Measurements of serum creatinine in the donors did not distinguish the different degrees of glomerulosclerosis found on biopsy. Our data indicate that donor glomerulosclerosis greater than 20% increases the risk of delayed graft function and poor outcome of transplanted kidneys. Therefore, we advocate the use of routine biopsies of kidneys from older (> 50 yrs) donors and those donors with nontraumatic cerebrovascular accidents, despite seemingly normal preprocurement serum creatinine.
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PMID:Glomerulosclerosis as a determinant of posttransplant function of older donor renal allografts. 765 61

It is a matter of concern that the elderly donor may have increased risks in the peri-operative period due to age-related changes in various organ. Nephrosclerosis, atherosclerosis and low GFR of an elderly kidney may portend a poor graft outcome. A retrospective analysis of our live related renal transplant program (from June 1989 to December 1993) revealed that 27 of the donors were above 60 years of age. 21 of the recipients have been followed up for more than 1 year. These patients were compared with a cohort of 25 patients (donor age < 45 years) with similar HLA match, immunosuppressive protocol, and follow-up period more than 1 year. Graft survival at 1 year was 86% and 88% in the recipients from elderly and younger donors respectively; 1 patient in the control group died of fulminant sepsis. Mean follow-up was 21.6 months in the study group and 22.8 months in the control group. Allograft function was evaluated by serum creatinine and differential GFR by Tc DTPA scan. Serum creatinine (mg%) was 1.3 +/- 0.2 and 1.4 +/- 0.2 in the study group and 1.3 +/- 0.3, 1.2 +/- 0.3 in the control group at 3 and 12 months respectively. Glomerular filtration rate (ml/min) was 36.5 +/- 11.6 and 43.7 +/- 12.4 in the recipients from elderly donors whereas those from the younger donors had GFR (ml/min) of 40.6 +/- 9.6 and 49.6 +/- 14.2 at 3 and 12 months respectively, GFR continued to improve in both groups with follow-up. There was no difference in incidence or severity of ATN In the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Should elderly donors be accepted in a live related renal transplant program? 786 13


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