Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The medical records of 1000 asymptomatic male air force personnel were examined retrospectively for the results of 15 yearly examinations of urinary sediment. The study covered the period 1968-82, beginning with the subjects aged 18-33 years. The cumulative incidence of two to four or more red blood cells per high power field found at one or more examinations was 38.7% after an average of 12.2 yearly examinations per person. In 161 subjects two to four or more red blood cells per high power field were found at two or more yearly examinations within a five year period. Intravenous pyelography in 58 cases disclosed asymptomatic nephrolithiasis in six. Cystoscopy performed in 11 cases identified one patient with urethritis, one with a vesical calculus, and one with transitional cell carcinoma of the bladder. Two years before diagnosis the patient with carcinoma had had a single transient finding of 10-12 red blood cells per high power field which was not investigated further. Cystoscopy was performed after an episode of macroscopic haematuria. Renal biopsy in one subject with recurrent microhaematuria and trace proteinuria disclosed focal glomerulonephritis. None of the remaining subjects with microhaematuria developed hypertension or proteinuria, and at the end of the study period all were active and free of urinary symptoms. The observed cumulative incidence of urological neoplasms at 15 years (0.1%) was consistent with that expected in Israeli men aged 18-40 (0.09%). Hence microhaematuria detected during a screening examination probably should not be regarded as a specific sign of a significant lesion and does not of itself warrant urological investigation in adults aged 40 or less.
 ...
PMID:Significance of microhaematuria in young adults. 641 99

Clinical data in 244 patients with IgA nephropathy and biopsy findings in 519 biopsies (107 patients had at least two biopsies) were analysed. Males predominated (73 per cent) and had more severe disease and a worse prognosis than females. The most frequent symptom was macroscopic haematuria, often with associated loin pain; however, this was typical only in young males. Hypertension was the major presenting feature in 23 per cent of patients. Urinary erythrocyte counts correlated with the presence of crescents on biopsy (p less than 0.0001). Serum IgA levels wer elevated in only 21 per cent, while IgM levels were raised in 43 per cent of patients. Two hundred and seventeen patients were followed for at least one year (mean 59.7 months, range 12-255 months). In 82 patients five-year follow-up and in 33 patients ten-year follow-up data were available. Five- and 10-year survival figures were 91.5 and 87.5 per cent respectively. Clinical resolution occurred in only 6 per cent of patients but in those who had biopsies following clinical resolution, diffuse mesangial cell proliferation and IgA deposits persisted in all. The rate of clinical deterioration correlated with proteinuria, hypertension, impaired renal function, crescents and sclerosed glomeruli on biopsy. Continuing high urinary erythrocyte counts were the strongest predictor of a progressive course.
 ...
PMID:The clinical course of mesangial IgA associated nephropathy in adults. 646 97

It is well known that patients with different kidney diseases have different prevalence of hypertension, independent of renal function. To investigate whether a lesion of some portion of the glomerular tuft, without renal insufficiency, is associated more frequently with high blood pressure, we undertook a retrospective study on 189 patients analyzing by means of multiple regression analysis as independent variables : type of glomerulopathy (IgA Nephropathy, Acute Glomerulonephritis, Membranous Glomerulonephritis and Focal Glomerulosclerosis), sex, age, body weight, plasma creatinine, plasma and urinary proteins, plasma urate, time interval first symptom-renal biopsy and steroid therapy. The dependent variable was a Principal Component formed by Mean Blood Pressure and an Antihypertensive Therapy score, calculated with a computer program. Focal Glomerulosclerosis patients had a higher prevalence of hypertension and a higher Principal Component value than patients of the other 3 groups. Plasma urate was correlated and time interval first symptom-renal biopsy was inversely correlated to Principal Component. These observations suggest that sclerosis of the glomeruli is the lesion most often associated with hypertension. On the other hand, since plasma urate is correlated with blood pressure also in "essential" hypertensives, it seems likely that hyperuricemia is a phenomenon secondary to hypertension.
 ...
PMID:Blood pressure in patients with four different primary glomerulopathies. 646 43

Eighty-two patients, 56 male and 26 female, biopsied since 1972 had IgA nephropathy. At the time of kidney biopsy, 24 patients were children and 58 were adults. In both groups the clinical course was documented in sufficient detail to allow prediction of disease outcome. Twenty-six (45%) of the adult patients had chronic renal insufficiency either at first evaluation or subsequently. Fourteen eventually required chronic hemodialysis. Hypertension as the initial sign of disease was seen more frequently in patients with chronic renal insufficiency. Adult males were more likely to have chronic renal insufficiency. The life table method was used to predict age at initiation of dialysis and kidney survival from date of onset of clinically apparent disease. Thirty-five percent of the male patients were predicted to require dialysis by age 40. Kidney death was predicted at 10 years from onset for 33% of male and 22% of all patients biopsied as adults. While all patients with progressive disease had over 2.0 g/24 h urinary protein excretion at least once, many individuals with serum creatinine concentration below 1.5 mg/dL showed marked fluctuation in degree of proteinuria, often exceeding 2.0 g/24 h. Thus, in some cases, degree of proteinuria was not a reliable predictor of outcome.
 ...
PMID:Iga nephropathy: presentation, clinical course, and prognosis in children and adults. 647 50

The clinical course of 123 pregnancies in 86 patients with biopsy-proven glomerular diseases have been studied. In 35 women the onset of nephropathy occurred during pregnancy. No complications were observed in more than half of the pregnancies. In the others, one third of the complications were obstetrical or fetal accidents, one third were renal manifestations (hypertension or deterioration of renal function) and one third were both causes. The lowest incidence of complications was observed in patients with membranous nephropathy and the highest in membranoproliferative glomerulonephritis patients. There were 6 spontaneous late abortion, 6 stillbirths and 5 neonatal deaths. 17 deliveries were preterm and 7 fetuses were small for gestational age. Hypertension appeared in 24 pregnancies, in 13 of which it was reversible and related to superimposed preeclampsia and in 11 it persisted after delivery (5 of these 11 pregnancies were in patients with IgA nephropathy). Renal function deteriorated in 10 cases during pregnancy. The deterioration was reversible in 6 and progressive in 4 (2 of whom had membranoproliferative glomerulonephritis). It is suggested that in most patients pregnancy does not change the natural history of glomerular disease.
 ...
PMID:Glomerular disease and pregnancy. A study of 123 pregnancies in patients with primary and secondary glomerular diseases. 669 75

Previous reviews of hematuria in children and adolescents have included patients with proteinuria and other renal functional abnormalities such as hypertension and reduced GFR. We report the clinico-pathological correlations in 76 pediatric patients, aged 3 to 19 years, who underwent a renal biopsy because of isolated hematuria during the 10-year period, 1972 to 1981. All specimens were examined by light and electron microscopy and immunofluorescence techniques. The overall prevalence of abnormal renal histology was 56%. The vast majority (41 of 43) of the abnormal biopsy specimens could be classified into four distinct histological categories: (1) Alport syndrome (N = 9); (2) IgA nephropathy (N = 8); (3) thinning of the glomerular basement membrane (N = 17); (4) vascular C3 staining (N = 7). The children were divided into three clinical subgroups (1) isolated microscopic hematuria ( IMH ), N = 42; (2) IMH plus a family history of hematuria in a first degree relative, N = 15; and (3) IMH plus at least one episode of gross hematuria, N = 19. A significant graded increase in the likelihood of obtaining an abnormal renal biopsy was demonstrated (X2 = 10, P less than 0.007) from groups one to three. Sex, age at onset, or duration of hematuria were not associated with an increased proportion of histopathologic abnormalities. These findings indicate that the yield of a renal biopsy in children with isolated hematuria can be predicted accurately from specific clinical characteristics.
 ...
PMID:Isolated hematuria in children: indications for a renal biopsy. 672 31

Clinical and pathologic features of IgA nephropathy were evaluated in 62 children (age range, 4 to 18 years; 46 boys, 16 girls) in a collaborative study carried out by members of the Southwest Pediatric Nephrology Study Group (SPNSG). Microscopic hematuria was present in all of the patients prior to renal biopsy and was associated with gross hematuria in 85%, proteinuria (greater than or equal to 2+) in 48%, hypertension in 6%, and depressed GFR in 25% of the patients. Renal biopsy specimens were reviewed and classified into three groups on the basis of light microscopy (LM): (1) normal glomeruli (16 patients), (2) mesangial hypercellularity (25 patients), and (3) focal and segmental proliferative and/or sclerosing glomerulonephritis (21 patients). Tubulo-interstitial changes, which were present in 56% of the biopsy specimens, showed no correlation with the duration of clinical disease. Peripheral glomerular capillary wall changes shown by electron microscopy (EM) were present in 40% of the biopsy specimens and were associated with more severe glomerular changes revealed by LM. Proteinuria and episodes of gross hematuria were associated with more severe histologic changes (group 3) and peripheral capillary wall changes demonstrated by EM. Mild patterns of glomerular damage (groups 1 and 2) were associated with female sex. The studies show that evidence of tubulo-interstitial damage and peripheral glomerular capillary wall changes are not uncommon in children with IgA nephropathy and suggest that these features may be harbingers of a more serious prognosis than previously thought.
 ...
PMID:A multicenter study of IgA nephropathy in children. A report of the Southwest Pediatric Nephrology Study Group. 676 87

Clinicopathologic features and follow up of 21 children with IgA nephropathy (Berger's disease) is discussed. The disease predominantly affected males. Although no definite prediction for any age group was observed, a majority (71.5%) of patient were six years or older. Macroscopic hematuria was the presenting feature in 71.5%, while as 28.5% had microscopic hematuria. Isolated proteinuria was not observed in any. 81% of the patients continue to have recurrent episodes of macroscopic hematuria, and 76% of the patients have microscopic hematuria during the symptom free intervals. Hypertension, azotemia and nephrotic syndrome were absent in all patients at the time of onset of the disease, and have not developed in any patient during follow up (mean 5.4 yrs). Serum IgA level elevated in only one (7.7%) of the thirteen patients in whom this was tested, and did not appear to be a diagnostic test of IgA nephropathy in children. The histologic features of renal biopsy did not correlate with known duration of the disease, extent of proteinuria at the time of biopsy or the degree of IgA deposits in the renal tissues. During childhood. IgA nephropathy appears to have an excellent prognosis, but longterm outlook can be projected only by following these children into adulthood.
 ...
PMID:IgA nephropathy (Berger's disease) - a clinicopathologic study in children. 685 35

The clinical and renal biopsy findings in a group of 12 patients with mesangial IgA nephropathy who had 22 pregnancies are recorded. Seventeen pregnancies were successful. Hypertension was noted in 9 pregnancies and in 12, features of pre-eclamptic toxaemia developed. One patient had post-partum eclampsia. Proteinuria tended to increase during pregnancy and one patient developed nephrotic syndrome which resolved after delivery. Glomerular lesions in these women differed from those in non-pregnant patients with mesangial IgA nephropathy. Focal and segmental proliferative and hyalinosis-sclerosis changes were seen far more frequently than is usual in biopsies from patients with mesangial IgA nephropathy, suggesting that focal and segmental lesions develop during pregnancy.
 ...
PMID:Mesangial IgA nephropathy in pregnancy. 700 Apr 72

Adequately biopsied renal tissue received in the Department of Pathology, University Hospital, Kuala Lumpur from 1,000 consecutive Malaysian patients during an eleven year period between 1970 and 1981 was reviewed. The youngest patient was 6 days old and the oldest 80 years. Both sexes were equally represented. The majority of the patients were Chinese (71%) with Malays and Indians comprising most of the remainder. Over half the patients (50.4%) presented with the nephrotic syndrome. Other modes of presentation included systemic lupus erythematosus, proteinuria and haematuria separately or in combination and hypertension. Minimal change (25.7%) and proliferative glomerulonephritis (24.8%) were present in about equal numbers and together accounted for over half of the cases (50.5%). Lupus nephritis was the third most common diagnosis (18.4%). In addition, there were patients with focal glomerulonephritis (5.4%), membranous glomerulonephritis (5.5%), Berger's disease (5.8%), amyloidosis (0.6%) and end stage renal disease (4.0%).
 ...
PMID:Morphological patterns of glomerular disease in renal biopsies from 1000 Malaysian patients. 707 29


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