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

One hundred and eight patients suffering from hypertension due to a unilateral parenchymatous neophropathy were studied over a period of one to eight years after treatment was starded. The aetiologies were diverse: harmonious hypoplasia, segmental hypoplasia, pyelonephritis, reflux nephropathy, hydronephrosis and tuberculosis. Thirty nine patients were treated surgically, with 50% good results. In 82 cases medical treatment was continued for at least a year with a 52% success rate. Such success was recorded in 94% of cases in which beta-blockers were used (38 cases). Surgical success was not dependent upon the period for which hypertension had been present. The best results were seen in cases of hydronephrosis and pyelonephritis and the worst in tuberculosis. Thirteen patients underwent surgery event though there was no unilateral increase in plasma renin levels. Seven were improved or cured. Ten patients underwent surgery with a renin activity 50% greater than on the healthy side, 9 being improved or cured. Treatment with beta-blockers, alone or in association with diuretics, controlled blood pressure in 90% of cases, regardless of the renin activity. Plasma renin activity in the renal veins is of good prognostic value in terms of the effectiveness of nephrectomy against hypertension. In Call cases, beta-blockers were more effective than surgery.
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PMID:[Hypertension due to unilateral parenchymatous nephropathy (author's transl)]. 3 35

To determine its utility as an aid in diagnosis of renovascular hypertension, we administered nonapeptide converting-enzyme inhibitor (CEI) (which inhibits conversion of angiotensin I to angiotensin II) (0.25 mg per kilogram) to 14 unselected hypertensive patients undergoing bilateral renal-vein catheterization. In seven (Group I) predominantly unilateral disease was discovered by angiography (renal-artery stenosis in six and hydronephrosis in one); in the remaining seven (Group II) no rennal-artery abnormality was found. In Group I, mean (+/- S.E.) ratio of involved to uninvolved renal-vein plasma renin activity (PRA) increased from 2.94 +/- 0.91 before to 8.36 +/- 2.94 after CEI (P less than 0.01). In Group II, the ratio (of the initially higher to the lower side) was 1.99 +/- 0.49 before and 1.17 +/- 0.07 after CEI (P greater 0.02). Post-CEI PRA was predicted by pretreatment PRA. Mean blood pressure fell in both groups after CEI, and the decrement was predicted by pre-CEI PRA. These data suggest that CEI can be of use at the time of renal-vein catheterization, serving to increase diagnostic accuracy by increasing the difference in PRA between the two sides when there is unilateral disease.
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PMID:Inhibition of angiotensin-converting enzyme for diagnosis of renal-artery stenosis. 20 50

Ablation of renal tissue makes the subject sensitive to hypertension-inducing mechanisms, especially those due to fluid expansion, either by Na-volume or whole blood. Such hypertensive mechanisms are prevented by deviation of urine flow into a vein. Ablation of the renal medulla, by acute hydronephrosis or chemically, also potentiates the hypertensive state. Transplantation of either the renal medulla or its interstitial cells (RIC) can prevent or reverse hypertension. Under the latter conditions, the protective mechanism appears to result from the secretion of an antihypertensive hormone by the RIC. Lipid extracts of renal medulla not only prevent and reverse the hypertensive state in the same manner as medullary transplants but, under certain conditions, exert an acute depressor effect. The RIC can undergo hyperplastic changes much in the manner of an endocrine structure. For these reasons, it is proposed that the RIC represent an antihypertensive endocrine organ whose putative hormone may be termed the renomedullary antihypertensive hormone (ARH). Additional data in support of these contentions are presented.
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PMID:Case for a renomedullary blood pressure lowering hormone. 35 40

A patient who presented with hypertension of recent onset was found to have unilateral hydronephrosis. Increased activity of the renin-angiotensin system was documented with renal-vein-renin concentrations. The hydronephrosis was due to a primary transitional cell carcinoma of the ureter. Following nephroureterectomy, blood pressure returned to normal and has remained so for two years.
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PMID:Reversible hypertension due to carcinoma of the ureter. 42 76

The value of radiological examinations in hypertension was analyzed in a series of 44 children. An i.v. urography had been performed in 43 cases with a pathological finding in 19 (44%). Renal angiography, employed in 19 cases, revealed abnormal findings in 12 (63%) patients. Micturating urethrocystography performed in 16 children gave no additional important information. The only complication noted was thrombosis of the femoral artery subsequent to renal angiography in one child less than one year of age. The diagnosis of hypertension based mainly on the i.v. urography in 12 cases but the renal angiography gave additional important information in 6 children. One child with obstructive hydronephrosis was also found to have a renal artery stenosis at renal arteriography. Based on these results, and particularly because secondary hypertension may frequently be treated surgically, we consider extensive radiological investigation with renal angiography is mandatory before receiving a final diagnosis of essential hypertension, and before starting long-term treatment.
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PMID:The radiological evaluation of children with hypertension. 51 Mar 18

The effect of age, sex and salt intake on the hypertension produced in homozygous (DI) and heterozygous (non-DI) Brattleboro rats and Long Evans rats was studied. The left kidney was removed at the age of 25, 35, 50 and 80 days (UNX 25, UNX 35, UNX 50, UNX 80), and 0.6% NaCl solution or water was offered as drinking fluid. In UNX DI rats drinking saline the mean value of blood pressure (BP) exceeded 150 torr. The highest values of BP were observed in DI UNX 25 females while no hypertension occurred in rats UNX 80. There was no correlation between individual values of BP and saline consumption in DI females with hypertension. However, individual BP values correlated with the urinary Na+/K+ ratio measured in the course of 24 h of water deprivation, due to age-dependent sodium excretion the values of which were highest in the UNX 25 group. Hydronephrosis was present in all DI rats with manifest hypertension. In hypertensive animals, BP values, Na+/K+ ratio and the frequency of hydronephrosis exhibited the same age dependence. The role of age and adaptability to the increased saline intake in the susceptibility of DI rats to experimental hypertension is discussed.
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PMID:Hypertension in rats with hereditary diabetes insipidus. The role of age. 56 Jun 79

1. The protective action of the renal medulla was studied in one-kidney renal-clip hypertension in rats with unilateral hereditary hydronephrosis and almost complete atrophy of the medulla of the affected kidney. 2. Rats were unilaterally nephrectomized. The first group had a normal kidney remaining, and the animals from the second and third groups were left with a hydronephrotic kidney and received renomedullary and renocortical autotransplants respectively. Two weeks later all rats were made hypertensive by placing a silver clip (0.2 mm) on the renal artery. 3. From the fourth day after clipping until the end of the experiment blood pressure was found to be significantly (P less than 0.01) lower in rats with medullary transplants than in the other groups. No differences in renal excretory function, plasma volume and plasma renin activity were found between the groups either before or during development of hypertension (5 and 21 days after clipping). Early in the course of hypertension (5 days) cardiac output was significantly (P less than 0.05) lower in the rats with medullary transplants than in the other groups, although an increase in plasma volume was noted in all three groups. At that time no difference in total peripheral resistance was found between the groups. 4. The results are consistent with the hypothesis that the renomedullary antihypertensive substance(s) mitigates hypertension by preventing a hypertensive haemodynamic response to sodium/volume overload.
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PMID:The mechanism of renomedullary antihypertensive action: haemodynamic studies in hydronephrotic rats with one-kidney renal-clip hypertension. 63 67

Six infants with hydronephrosis developed hypertension during the first year of life. Five of them, all with proved or suspected acute urinary tract infection, had transient hypertensive episodes lasting for 7 to 17 days. One of the five infants, who had ureteropelvic junction obstruction and unilateral hydronephrosis, remained normotensive after nephrectomy. The sixth patient, with bilateral hydronephrosis and elevated peripheral vein renin activity, has had persistent hypertension. We discuss possible mechanisms underlying hypertension in these infants and suggest that young patients with hydronephrosis may be unusually predisposed to acute hypertensive episodes.
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PMID:Arterial hypertension in infants with hydronephrosis. Report of six cases. 83 20

In a Zurich outpatient clinic in 1975 hypertension was found in 10.4% of 8228 patients (3657 females and 4571 males). Essential (primary) hypertension was found in 92.9% of all hypertensives. Among secondary forms of hypertension (7.1%) renal hypertension was the most common (5.8%) with 4.9% for hypertension of renal parenchymatous origin, .8% renovascular hypertension, and .1% hypertension associated with unilateral hydronephrosis. In 2 patients (.2%) the underlying disease was primary aldosteronism and in 5 (.6%) coarctation of the aorta. In 4 females (.5%) hypertension was caused by oral contraceptives. Patients with essential hypertension had higher body weight than those with normal blood pressure. These differences were statistically significant in young and middle-aged patients. The percentage of primary hypertension was significantly high. In only 18 (2.1%) of 854 hypertensives was a curable form of high blood pressure found (hypertension caused by renal artery stenosis, hydronephrosis, aldosterone-producing adenoma of the adrenal gland, and oral contraceptives). The very low percentage of curable forms of high blood pressure should be kept in mind when deciding on expensive procedures in a search for secondary forms of high blood pressure.
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PMID:[Primary and secondary hypertension in polyclinical patients]. 85 17

Among eight patients with unilateral hydronephrosis and hypertension, peripheral plasma renin activity was normal in seven and borderline high in one. Four patients had hydronephrotic/contralateral kidney renin ratios of greater than 1.5, suggesting excessive renin release from the diseased kidney, and ratios between contralateral kidney and peripheral blood of less than 1.2, indicating suppressed renin production in the contralateral kidney. Nephrectomy normalized blood pressure in each of these patients. Two patients had hydronephrotic/contralateral kidney renin ratios of less than or equal to 1.3 or contralateral kidney/periphery ratios of greater than 1.2, suggesting ischemia of the contralateral kidney; pyeloplasty or nephrectomy, or both, failed to improve the hypertension. Postoperative changes in blood pressure correlated with changes in peripheral renin (r = 0.90; P less than 0.01). These data suggest that hypertension associated with unilateral hydronephrosis is partly renin-dependent; and renal vein renin values are helpful in selecting patients for surgery.
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PMID:Curable hypertension with unilateral hydronephrosis. Studies on the role of circulating renin. 90 42


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