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

Renal tissue was obtained from 36 patients with renal cell carcinoma, some of whom received renal arterial embolization. The removed specimens was examined histopathologically and the concentration of some vasoactive substances in these patients was measured. Nephrectomy alone produced no discernible changes in blood pressure, vasoactive substances determined or histopathological findings of the kidney. Renal arterial embolization raised the blood pressure in association with the elevation of plasma renin activity (PRA) and urinary prostaglandin (PG) E2 excretion. A linear relationship was found to exist between PRA and mean blood pressure (r = 0.70, p less than 0.001). Hyperplasia of the juxtaglomerular (JG) apparatus, and high granularity of sudan black B granules in renomedullary interstitial cells were confirmed in removed kidneys of patients who had received embolization alone. Subsequently high renin production would be anticipated to influence overproduction of renal PG E2 in acute ischemic kidney in patients with renal cell carcinoma, and hypertension following renal arterial embolization appears to be caused by the hyperplasia of the JG apparatus.
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PMID:Hyperplasia of juxtaglomerular cells and renomedullary interstitial cells after renal arterial embolization in patients with renal cell carcinoma. 306 3

The manner of presentation and tumour stage in 52 consecutive patients with renal carcinoma who were treated surgically between 1974 and 1979 (group I) and 112 patients treated similarly between 1980 and 1985 (group II) were reviewed. In group I 16 cases (31%) were discovered incidentally compared to 50 cases (45%) in group II. Before the year 1980 most of the tumours were discovered incidentally at the time of intravenous urography (IVP) or angiography performed for examinations of urinary tract infection or hypertension. After 1980 most incidentally discovered tumours were found at ultrasound or computed tomography (CT) examinations. The tumour stage was lower in the incidentally discovered cases than in cases where the diagnosis was suspected. Routine use of excretory urography, computed tomography, ultrasound, bone scans and other effective diagnostic studies has led to earlier diagnosis, lower stage and possibly better survival in incidentally found cases of renal carcinoma than in cases when the diagnosis was suspected.
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PMID:Incidentally detected renal carcinoma. 306 75

Renal arterial embolization and subsequent nephrectomy or nephrectomy alone were performed in 34 patients with renal cell carcinoma. Renal arterial embolization caused a blood pressure elevation concomitant with an increase in plasma renin activity (PRA), urinary aldosterone excretion or urinary prostaglandin (PGE2) excretion. Subsequent nephrectomy normalized hypertension and reduced the levels of these vasoactive substances. There were significant relationships between the increase in mean blood pressure and the increase in PRA, the increment in mean blood pressure and the increment in urinary aldosterone excretion, and the increase in PRA and increase in log urinary PGE2 excretion following embolization. These evidences suggest that enhancement of the renin-angiotensin-aldosterone system participates in the development of hypertension following embolization, and increased PRA may play an important role in the release of urinary PGE2.
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PMID:Changes of vasoactive substances following embolization for renal cell carcinoma. 322 30

Since the introduction of new non-invasive diagnostic techniques such as abdominal ultrasound and computerized tomography, simple renal cysts are diagnosed with increasing frequency. Over 30% of patients over 50 years of age are found to have simple renal cysts of different size. A cystic renal mass may represent a simple renal cyst without clinical relevance, a cystic renal carcinoma, early evidence of polycystic kidney disease in a young patient, a rare cause of renal hypertension, a source of infection in a symptomatic patient (infected renal cyst), or a manifestation of an infectious disease (renal abscess, echinococcus cyst). The differential diagnosis and management of a cystic renal mass therefore remain a clinical problem. In the past, surgical exploration of a cystic renal mass was frequently performed. Today, modern diagnostic techniques such as ultrasound-guided percutaneous cyst puncture with cytological analysis of the cyst content, or computerized tomography, are considered the methods of choice. They are particularly useful in case of doubt about the dignity of a cystic renal mass. The determination of renal venous renin levels may be useful in differentiating the causal role of a renal cyst in a patient with hypertension. The management of a cystic renal mass depends on the underlying disease.
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PMID:[An incidental finding of renal cysts: routine occurrence or a finding deserving clarification?]. 329 67

It is noted that while a wide variety of syndromes have been associated with hypernephroma in the clinical literature, there is clear understanding of the pathophysiology of these effects only in the cases of the endocrine disorders where direct tumor production of hormone can be demonstrated in vitro. Furthermore, this knowledge has done little to alter the care of patients with the disease, except for indications that indomethacin might be of benefit in some patients with hypercalcemia and that one might consider the use of converting enzyme inhibitors in patients with hypernephroma and hypertension. The overall approach to the disease is still surgical. Resection of the tumor also removes the paraneoplastic syndrome. Persistence or recurrence of a syndrome suggests the continued presence of the neoplasm, with the considerations for prognosis which that fact entails. To that degree, at least, these conditions are useful as tumor markers, but such use is limited because they are inconsistent. Further studies of pathophysiology of paraneoplastic syndromes will lead to better understanding of processes of cell differentiation and regulation, and possibly better ways to manage the patients in which they occur.
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PMID:Paraneoplastic syndromes in hypernephroma. 330 61

A 63-year-old caucasian male with systemic leukocytoclastic vasculitis involving the skin, lungs, and gastrointestinal tract was found to have a renal cell carcinoma at autopsy. A 77-year-old-woman with a history of hypertension was felt to have temporal arteritis that was confirmed by biopsy. The autopsy revealed a renal cell carcinoma in association with widespread giant cell arteritis. The possible association of renal cell carcinoma with vasculitis and an assessment of the possible clinical usefulness are presented and cases of vasculitis with renal neoplasms are briefly reviewed.
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PMID:Renal cell carcinoma and vasculitis: report of two cases. 357 71

Renal involvement in the tuberous sclerosis complex includes angiomyolipomas, cysts, and carcinomas. Angiomyolipomas, despite a sometimes frightening histopathologic appearance, are benign. Cystic disease, apparently resulting from tubular epithelial hyperplasia, causes hypertension and renal insufficiency, progressing to end-stage renal disease. The same epithelial hyperplasia predisposes to renal carcinoma.
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PMID:The renal lesions of tuberous sclerosis. 361 20

Unilateral parenchymatous kidney disease associated with high blood pressure represents a potentially curable form of hypertension. Surgery may normalize blood pressure in a substantial number of these patients. Curable renal parenchymatous hypertension includes unilateral tubulointerstitial kidney diseases such as chronic pyelonephritis, reflux nephropathy, segmental hypoplasia and radiation nephritis, hydronephrosis, simple renal cysts, traumatic kidney lesions and renal tumors associated with high blood pressure. Renal ischemia and in turn activation of the renin angiotensin system is involved in the pathogenesis of hypertension in most of these patients. In patients with unilateral kidney disease and hypertension, both an operative and a medical therapeutic approach have a high success rate. Good candidates for nephrectomy are young patients with severe hypertension, strict unilateral disease, normal plasma creatinine levels and minimal function of the involved kidney. In unilateral hydronephrosis reconstructive surgery or nephrectomy may cure or improve hypertension in the vast majority of the patients. Surgically correctable hypertension has also been reported in some patients with large renal cysts and renal tumors (hemangiopericytoma, Wilm's tumor, hypernephroma, renal pelvic tumor).
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PMID:Curable renal parenchymatous hypertension: current diagnosis and management. 390 29

A total of 25 patients with renal cell carcinoma underwent angioinfarction of the tumor using absolute ethanol. An average of 15 ml. absolute ethanol was injected into the main renal artery through a balloon occlusion catheter. Complete cessation of renal arterial flow could be demonstrated in all cases. The post-embolization syndrome of pain, nausea, vomiting, hypertension and fever was minimal compared to other methods of renal artery occlusion. Of the patients 21 underwent post-infarction transabdominal radical nephrectomy without intraoperative or postoperative complications attributable to the injection of absolute ethanol. No damage to extrarenal tissue was noted at operation. Subsequent surgical dissection was facilitated, particularly in cases of large tumors when control of the renal pedicle often is difficult. Median blood loss was 725 ml. In light of recent reports concerning the benefit of angioinfarction and nephrectomy in metastatic disease a similar approach may be applicable to localized disease. This pilot study shows the safety of preoperative angioinfarction with absolute ethanol and may be used as a reference for future randomized prospective studies comparing angioinfarction and nephrectomy to nephrectomy alone for localized renal cell carcinoma.
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PMID:Preoperative angioinfarction of localized renal cell carcinoma using absolute ethanol. 396 74

Although secondary hyperaldosteronism due to renal vein thrombosis may occur as a result of renal cell carcinoma or adrenal cortical carcinoma, primary hyperaldosteronism is rarely associated with the latter. This paper describes a patient with adrenal cortical carcinoma who presented with the clinical features of primary hyperaldosteronism 1 year after hypertension had been diagnosed; intravenous pyelography had not been done then. Drug therapy was ineffective, and the patient died 10 weeks after presentation.
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PMID:Adrenal cortical carcinoma: an unusual cause of hyperaldosteronism. 635 90


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