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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The risk for kidney cancer was examined in a Danish cohort of 192,133 people on a hospital discharge register who had been given a diagnosis of hypertension, heart failure, or edema, and were presumed to be probable users of diuretics. The subjects were identified from 1977 to 1987 and followed-up for cancer through 1987. A total of 10,630 cancers was observed. While the risk for all cancers was increased slightly (standard mortality ratio [SMR] = 122, 95 percent confidence interval [CI] = 120-124), the risk for renal cell carcinoma was more than doubled (SMR(men) = 221, CI = 192-253; SMR(women) = 246, CI = 213-283). Increased risks were found in all age groups, and, although surveillance bias was present initially, the risk increased consistently in the years following discharge. Risk estimates for individuals discharged with hypertension were similar to those for the total cohort. Use of diuretics was validated in a random sample of 100 individuals. More than 70 percent were taking diuretics at the time of discharge. The increased risk for renal cell carcinoma in this cohort may indicate either that diuretics are involved in the etiology of renal cell carcinoma or that the risk can be attributed to confounders, including smoking, which affect risk for both the discharge diagnosis and renal cell carcinoma.
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PMID:Diuretics may increase risk of renal cell carcinoma. 161 17

In a population-based case-control study of kidney cancer in New South Wales, Australia, data from structured interviews with 489 cases of renal cell cancer (RCC) and 147 cases of renal pelvic cancer (CaRP) diagnosed in 1989 and 1990, and 523 controls from the electoral rolls, confirmed the link between obesity and RCC. In addition, regular consumption of 'diet' pills independently increased the risk for this cancer. A diagnosis of hypertension at least two years before interview raised the risk for RCC, and regular use of beta-blockers, a class of antihypertensive drug, independently increased the risk for RCC and CaRP (risk ratio = 1.5-1.8). No independent effect was found for use of diuretics. Additional information provided by this study includes increased risks associated with kidney injury (RCC, CaRP)--possibly attributed to recall bias--and kidney infection (CaRP), as well as a nonsignificantly raised risk linked with kidney stones (RCC, CaRP) and a significantly reduced risk for RCC in persons giving a history of lower urinary tract infection. No significant association of RCC was found with hormonal factors (age at menarche or menopause; child-bearing; regular use of oral contraceptives or estrogens; hysterectomy or oophorectomy).
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PMID:Risk factors for kidney cancer in New South Wales, Australia. II. Urologic disease, hypertension, obesity, and hormonal factors. 161 19

A case of simultaneous double cancer on functional solitary kidney is reported. A 72-year-old man was admitted to the Department of Internal Medicine with angina, hypertension and diabetes mellitus. After treatment involving percutaneous transluminal coronary angioplasty, he was sent to the Department of Urology to check the microhematuria. Cystoscopy showed normal interior of urinary bladder. Drip infusion pyelography and computed tomography demonstrated a tumor mass on the upper pole of the right kidney and atrophic left kidney. Preoperative diagnosis was right renal cell carcinoma. However, an additional pelvic tumor was found during surgery, and a partial nephrectomy was performed. Histologic examination confirmed the presence of 2 separate and distinct malignant entities: a renal cell carcinoma and a non-invasive transitional cell carcinoma. Postoperative recovery has been uneventful and without hemodialysis for 16 months. This is the 19th case of simultaneous occurrence of renal cell carcinoma and transitional cell carcinoma in the same kidney and the 1st case in the patient with a functional solitary kidney in the Japanese literature.
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PMID:[Simultaneous double malignant tumors on functional solitary kidney: a case report]. 163 25

With the advent of sonography and CT, renal cell carcinoma has increasingly been diagnosed in its early stage, with simple hematuria or no symptoms as the incidence of patients with masses and extrarenal extensions decreased. Correlating the clinical manifestations with stage, hematuria and pain may not imply an advanced lesion (31.4% Stage I). By adequate use of B ultrasonography and/or other instrument, many of renal cell carcinoma could be detected in its asymptomatic stage, a crucial requirement for better therapeutic results. The authors' data showed that fever, elevated ESR, varicocele and general malaise did imply advanced lesions or possible early metastasis after operation. On the other hand, complication with hypertension or erythremia could speak for an early lesion if diagnosis is made in time. Therefore, stratification of the extrarenal manifestations into endocrine and non-endocrine phases may help assess prognosis.
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PMID:[A new concept on clinical manifestations in relation to staging of renal cell carcinoma]. 178 54

A 70-year-old woman was treated for renal cell carcinoma with recombinant human tumor necrosis factor, 450,000 U/m2 of body surface area, daily for 5 days, once a month. She had had psoriasis for 25 years. After two courses of recombinant human tumor necrosis factor her psoriasis resolved. A 40-year-old man with severe psoriasis was subsequently treated with a total of seven complete and incomplete 5-day courses of recombinant human tumor necrosis factor at doses of 50,000 to 300,000 U/m2/day. Significant toxicity (fever, chills, hypertension, and hypotension) was encountered. Partial resolution of the lesions was seen. Tumor necrosis factor is an active agent in psoriasis.
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PMID:Response to tumor necrosis factor in two cases of psoriasis. 186 45

We report a case of renal adenocarcinoma with contralateral stenosis of the renal artery. We describe the causes of hypertension in renal cancer and investigative techniques leading to the discover of a vascular implication in hypertension. We debate of the different surgical techniques for renal revascularisation with special regard to splenorenal anastomose. This is the method of revascularisation used in this case.
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PMID:[Hypernephroma with contralateral renal artery stenosis. Therapeutic choices]. 192 56

Whether extensive ablation of renal mass in humans leads to progressive glomerulosclerosis, proteinuria, and hypertension, as it does in animal models, is a matter of controversy. We have studied kidney function in six patients who underwent enucleation of a renal cell carcinoma in a solitary kidney. Four patients had previously had a nephrectomy. The two others each had one atrophic, nonfunctioning kidney. Serum creatinine levels before surgery were within the normal range (mean, 99.9 mumol/L [1.13 mg/dL]). Two weeks after tumor enucleation, creatinine levels were significantly higher than the preoperative values (mean, 124.6 mumol/L [1.41 mg/dL]). The follow-up period varied from 10 to 23 months. In all patients, kidney function improved during the following months. Serum creatinine levels nearly reached preoperative values in all patients (mean, 105.2 mumol/L [1.19 mg/dL]). None of the patients showed a progressive deterioration in renal function or proteinuria. We found a modest increase in blood pressure in two patients who had been normotensive before surgery. In conclusion, tumor enucleation in a solitary kidney did not cause significant renal injury to the remnant kidneys in our patients, at least in the short term.
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PMID:Renal function after tumor enucleation in a solitary kidney. 199 67

A longitudinal study of 34 198 non-Hispanic white California Seventh-day Adventists identified incident cases of renal carcinoma over six years of follow-up. The use of antihypertensive medications and self-reported hypertension had estimated age-sex adjusted incidence rate ratios of 4.51 and 2.90 respectively. These were relatively unchanged by stratifying on additional variables that may have been confounders. Cases diagnosed later during the follow-up period had the strongest association with hypertension, making the alternative explanation that the cancer may have caused the hypertension less likely. Being married in 1976 (amongst females at least) was also associated with a marked elevation of risk. Point estimates of effect suggested that frequent (greater than or equal to 3 week) consumption of fruit (RR = 0.21) and salad vegetables (RR = 0.34) may be protective for this cancer, although the 95% confidence interval did not quite exclude the null value.
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PMID:Hypertension, antihypertensive medication and risk of renal carcinoma in California Seventh-Day Adventists. 208 9

Crude estimation of the selection probability ratio (SPR), described previously, was extended to stratified and multivariate estimation and used to assess selection bias in a case-control study of renal adenocarcinoma. It was shown that the directly pooled estimate of the SPR, using the same weights as the directly pooled estimate of the exposure odds ratio (OR) from the case-control study (assuming the OR and SPR are common to all strata and data are abundant), can be multiplied with the OR to yield an adjusted OR that is free from selection bias. Medical records of 548 interviewed cases were compared with 640 noninterviewed cases, and interviews of 640 controls were compared with mailed questionnaires from 272 (60%) of the noninterviewed controls. Age-sex-adjusted point estimates of SPRs ranged from 0.65 to 1.4. Multivariate estimates from binomial regression ranged from 0.34 to 2.0. Higher socioeconomic status and history of renal stones were predictors of participation by both cases and controls. Obesity in women, hypertension, and nonsmoking were predictors in cases only. Heart disease was associated with control participation and case nonparticipation. This study cast doubt on the OR for obesity in women and hypertension in the case-control risk analysis.
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PMID:Analysis of selection bias in a case-control study of renal adenocarcinoma. 209 Feb 81

Erythropoietin is a glycoprotein hormone of primarily renal origin that promotes the proliferation and differentiation of erythrocyte precursors. Technological advances have resulted in the production of recombinant hormone suitable for therapeutic use and have permitted significant progress in the characterization of the physiologic and pathologic processes involved in endogenous erythropoietin production. In situ hybridization studies have shown that erythropoietin production in the hypoxic kidney occurs primarily in peritubular cells, most likely endothelial cells. In renal carcinoma associated with polycythemia, however, erythropoietin mRNA has been detected in the tumor cells, which are tubular in origin. New information regarding the biochemistry of the erythropoietin receptor has been gleaned subsequent to the cloning of the gene encoding the receptor; however, much remains to be learned about the interaction of the hormone with its target cells. With regard to clinical experience, recombinant erythropoietin has been shown to correct the anemia associated with chronic renal failure in patients requiring dialysis, having a significant beneficial effect on the overall physical and psychological state of the patient; the major adverse effect of such treatment is hypertension. The role of recombinant erythropoietin in predialysis patients, patients with anemias of other origin, and other clinical settings is currently being evaluated.
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PMID:Erythropoietin: physiology and clinical experience. 219 61


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