Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

---

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

Diabetic glomerulosclerosis is the most frequent cause of renal disease in patients with type II diabetes mellitus (DM), sometimes accompanied by vascular lesions. However, other glomerular pathologies are important in these patients. The aim of this study was to evaluate the prevalence of non-diabetic nephropathy (NDN) in selected patients with type II DM, and to identify clinical markers that may predict its presence in this population. We reviewed 20 renal biopsies performed on twenty patients with type II DM. Nine of them showed diabetic nephropathy (DN) (45%), whereas eleven showed NDN (55%): 1 IgA nephropathy, 3 vasculitis and 7 membranous nephropathy. We found no differences between the two groups with regard to sex, duration of DM, insulin therapy, glycosylated haemoglobin, proteinuria, presence of nephrotic syndrome, hypertension, serum IgA level or renal size. The NDN group had haematuria in 63.6%, whereas the patients with NDN had it in 44.4% (NS). Body mass index was higher in NDN patients (30 +/- 6.7 vs 22 +/- 2.9; p < 0.01), The same was true for creatinine clearance (82.2 +/- 51.4 ml/m vs 40.4 +/- 19.6 ml/m; p < 0.05). The age at the moment of diagnosis was higher in ND patients (67 +/- 11.2 vs 54.3 +/- 4.6; p < 0.05). The 3 patients who had diabetic retinopathy were found to have DN on renal biopsy (diagnostic specificity = 100%), although 66.7% of the patients with diabetic glomerulopathy had no retinopathy. We conclude that patients with type II DM with renal findings suggesting non-diabetic renal disease frequently it have NDN, and a renal biopsy must be performed. The presence of retinopathy has a predictive value of 100% in predicting DN, therefore its existence may make this diagnostic procedure unneccesary.
...
PMID:[Renal histological lesions in patients with type II diabetes mellitus]. 1208 17

The current recommendations of kidney biopsy in childhood idiopathic nephrotic syndrome (CINS) were put forward to minimize unnecessary kidney biopsies in underlying minimal change disease (MCD). However, there remains a diversity of opinion about the criteria for biopsying children with idiopathic nephrotic syndrome. This study was conducted to prospectively study their usefulness in avoiding biopsies in MCD and to evaluate further modifications for minimizing biopsies in CINS. Of 400 consecutive CINS patients, 222 patients were subjected to kidney biopsy according to the current recommendations. The histopathology spectrum of these selectively biopsied children revealed focal segmental glomerulosclerosis (FSGS) in 39%, MCD in 34.2%, membranoproliferative glomerulonephritis (MPGN) in 16.2%, mesangioproliferative glomerulonephritis (MesPGN) in 7.6%, membranous nephropathy (MN) in 1.8%, and diffuse mesangial sclerosis (DMS) in 0.9%. We observed that despite the current recommendations and efforts to minimize biopsy, 34% of children had MCD on histopathology. Two or more clinical (hematuria and hypertension) or biochemical (renal insufficiency) parameters were present in all children with MPGN. Low C3 was present only in children with MPGN. All the steroid responders were found to have MCD, FSGS, or MesPGN on biopsy. Cyclophosphamide response correlated better with steroid responsiveness ( P=0.02) than with histo- pathology ( P=0.80) in MCD, FSGS, and MesPGN. Based on these observations, we suggest some modifications in current recommendations for kidney biopsy to minimize biopsying children with MCD. These are (1) biopsies in children (age 1-16 years) should be restricted (a) to a subgroup with two or more clinical and biochemical parameters and (b) in steroid non-responders, (2) the decision to administer cyclophosphamide should be based on steroid response pattern without requiring a prior routine biopsy.
...
PMID:Do current recommendations for kidney biopsy in nephrotic syndrome need modifications? 1210 3

Bone marrow transplant nephropathy is a known complication of bone marrow transplantation. Bone marrow transplantation can cause various rare kidney diseases such as membranous nephropathy and focal segmental glomerulosclerosis. Idiopathic membranoproliferative glomerulonephritis is rare in children. Here the authors report on a 5-year-old pediatric autologous stem cell recipient, in whom type I membranoproliferative glomerulonephritis developed 111 days after bone marrow transplantation and presented with hematuria, hypertension, proteinuria, and renal failure.
...
PMID:Membranoproliferative glomerulonephritis develops in a child with autologous stem cell transplant. 1246 64

In 53 children and adolescents (47 males, 6 females) with lupus nephritis, clinical features at the time of renal biopsy were analyzed and correlated with pathohistological findings. The mean age at the time of diagnosis of systemic lupus was 12.9 +/- 2.6 (SD) years; the mean ages at the time of diagnosis of lupus nephritis and renal biopsy were 13.5 +/- 2.6 and 13.6 +/- 2.5 years, respectively. The most frequent clinical and laboratory features of lupus nephritis at the time of biopsy were proteinuria (100% of patients), haematuria (88%), nephrotic syndrome (38%), hypertension (32%), and decreased glomerular filtration rate (26%). On initial biopsy, the most frequent finding was diffuse proliferative glomerulonephritis (in 64.1%), followed by "mesangiopathy" (20.8%), minimal changes (7.5%), membranous nephropathy (5.8%), and focal proliferative nephritis (1.9%). Nephrotic syndrome, hypertension, decreased glomerular filtration rate, and haematuria were significantly associated with WHO classes IV and III of lupus nephritis.
...
PMID:[Lupus nephritis in children and adolescents: clinical and morphologic aspects and clinico-morphologic correlations]. 1258 6

Nephrotic syndrome in children is a clinical manifestation of different histopathological subtypes. There is a paucity of recent large studies dealing with the histopathological spectrum from developing countries. A prospective study was performed from January 1990 to December 2000 at our center, involving 600 children (with age of onset up to 16 years) with idiopathic nephrotic syndrome (INS). The objectives were: (1) to study the histopathological distribution of different subtypes of INS and (2) to compare the clinical and biochemical parameters at the time of diagnosis of minimal change disease (MCD) with non-MCD subtypes. For the purpose of this study we analyzed only those children with INS who underwent biopsies. The study group included 290 children in which adequate biopsy reports were available. There were 213 males and 77 females. Mean age at onset of INS was 7.9+5.1 years. Facial edema was found in 286 (98.6%), microhematuria in 120 (41.3%), gross hematuria in 7 (2.5%), and hypertension in 77(26.8%) patients. All patients of the study group were seronegative for HBsAg and HIV. Focal and segmental glomerulosclerosis (FSGS) was the most common histopathological subtype, occurring in 110 of 290 children (38%). Other subtypes included MCD in 95 children (32%), membranoproliferative glomerulonephritis (MPGN) in 44 children (15%), mesangioproliferative glomerulonephritis in 33 children (11%), membranous glomerulonephritis in 5 children (2%), and diffuse mesangial sclerosis in 3 children (1%). In children under 8 years of age, MCD was the most common entity, whereas FSGS predominated in children with age at onset greater than 8 years. The age at onset of nephrotic syndrome was significantly higher in the non-MCD group than the MCD group. The incidence of hypertension, microhematuria, and gross hematuria was significantly lower in the MCD group. MCD remains the most common histopathological subtype in Indian children with INS and onset under 8 years of age. The incidence of MPGN continues to be high. MCD can be differentiated from non-MCD subtype by younger age at onset, absence of hypertension, and absence of microscopic hematuria.
...
PMID:Histopathological spectrum of childhood nephrotic syndrome in Indian children. 1274 93

Two hundred eighty patients underwent renal biopsy during the period of 1995-1999 in five nephrological centers of Lithuania. All renal biopsies materials were examined in the State Center of Pathology. In 20 patients (7.1%) membranous nephropathy was found. The main clinical presentation at the moment of renal biopsy were nephrotic syndrome (55%) and arterial hypertension (55%). Glomerulosclerosis was found in 30% of patients, interstitial fibrosis--in 40% of patients. The results of analysis showed multiple risk factors for renal failure progression: initial renal failure (p=0.000), systolic and diastolic hypertension (p=0.009 and p=0.009), proteinuria (=1 g/l, =3 g/l) (p=0.026). Membranous nephropathy was found to have a relatively good long-term prognosis - the renal survival rate in 5 years was 84.2%. Kaplan-Meier survival analysis showed that initial renal failure was risk factor (logrank p=0.018, Breslov p=0.032) associated with development of end-stage renal disease in 5 years.
...
PMID:[Prognosis of chronic renal failure in patients with membranous nephropathy]. 1276 14

Membranous nephropathy is a relatively common glomerular disease found to underlie both nonnephrotic and nephrotic proteinuria. In adults, about 75% of cases are primary (idiopathic) and 25% are secondary to a wide variety of causes, including neoplasia, infections, autoimmunity, and drugs. Presenting features are not distinctive enough to permit a diagnosis without a renal biopsy examination. Serologic studies are normal in the idiopathic disorder. The morphologic features are characteristic and include gradual thickening of the capillary wall caused by the in situ deposition of immune complexes accompanied by new basement membrane synthesis. The natural history of the untreated disorder is variable. Spontaneous remissions (complete and partial) of proteinuria, usually accompanied by stable renal function, eventually occur in 40% to 50% of patients and the remainder slowly progress to end-stage renal disease (ESRD) or die of complications or from unrelated disease after 5 to 15 years. Factors associated with a progressive course include older age at onset, male gender, persisting hypertension, hyperlipidemia and/or hypoalbuminemia, reduced renal function at discovery, persisting nephrotic range glomerular proteinuria, concomitant tubular proteinuria, and advanced glomerular damage with chronic tubulointerstitial fibrosis.
...
PMID:Diagnosis and natural course of membranous nephropathy. 1292 20

Membranous nephropathy remains the most common cause of nephrotic syndrome in adults. The common variant is idiopathic membranous nephropathy with no evidence of any known precipitating factors. Membranous nephropathy also occurs as a secondary form in association with inflammatory or neoplastic diseases. Prognosis is mostly favorable as shown by the frequency of spontaneous remissions which averages 30%, although about one-third of patients progress to end-stage renal failure. Risk factors for a poor prognosis include severe proteinuria, hypertension, older age, male gender and impaired renal function. Therapy should include an ACE-Inhibitor and/or angiotensin-II receptor blocker to lower proteinuria (blood pressure < or =130/80 mmHg). The majority of patients should be observed for six months whilst receiving conservative treatment before deciding about an immunosuppressive approach. The debate over its management continues today. Steroids alone are ineffective. Evidence-based medicine supports the use of cyclosporine or the Ponticelli regimen (monthly cycling routine of chlorambucil or cyclophosphamide alternating with prednisone).
...
PMID:[Membranous glomerulonephritis]. 1456 65

The association of membranous glomerulonephritis with benign tumors is rarely described. This report represents, to the best of our knowledge, the first documented account of the simultaneous occurrence of juxtaglomerular cell tumor of the kidney and membranous glomerulonephritis. A young Chinese woman presented with hypertension and proteinuria, whereupon investigations disclosed a renal tumor. She underwent surgical resection, and histologic examination of the tumor revealed CD34-positive uniform polygonal cells with accompanying mast cells, disposed in sheets with focal papillary pattern punctuated by cytokeratin-positive tubular structures. Characteristic rhomboid crystalline granules were identified ultrastructurally. The kidney adjacent to the tumor showed features of membranous glomerulonephritis and hypertensive arteriopathy. Proteinuria improved following tumor resection, but the patient had persistent hypertension attributable to renal hypertensive arteriopathy. This report also highlights the recently described observation of CD34 positivity in juxtaglomerular cell tumors.
...
PMID:A case of juxtaglomerular cell tumor associated with membranous glomerulonephritis. 1457 36

The negative association between gout and rheumatoid arthritis is widely accepted, and gout is also speculated to be rare in systemic lupus erythematosus (SLE), as only a few sporadic cases have been reported. From 1985 to 2001 we encountered 15 lupus patients at Chang-Gung Memorial Hospital, including two with lupus-scleroderma and one with lupus-scleroderma-polymyositis overlap syndrome coexisting with gout. This study retrospectively analyses the clinical and laboratory characteristics of these patients. A lower female predominance is found, and most patients developed gout after the onset of SLE, although gout preceded SLE in two cases. Measurement of serum uric acid and 24-h urine uric acid found all of the patients to be hyperuricaemic and underexcretors of uric acid. Furthermore, most of the patients (14/15) were receiving diuretics. Also, many had hypertension and serious cardiovascular diseases. Renal impairment during gouty attacks seemed to be a predisposing factor for developing end-stage renal disease. Gouty arthritis usually occurred during relative SLE inactivity, podagra was frequent, and tophi were found in a few patients. Compared with the unselected population of SLE patients, the cases studied here had a higher incidence of chronic arthritis, malar rash, haematologic disorder, photosensitivity, serositis and neurologic disorder. Renal disease in the patients sampled was frequently membranous nephropathy.
...
PMID:Gout in systemic lupus erythematosus and overlap syndrome - a hospital-based study. 1457 59


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

---