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

The authors describe a case report of a previously healthy rotary-wing aviator who developed hypertension of unknown etiology. His 30 pack/year smoking history and hypercholesterolemia (ranging from 224-268) were significant. The initial evaluation revealed an elevated creatinine of 1.7 (normal to 1.5). Right-sided hydronephrosis was noted on ultrasound and the right kidney was poorly visualized on IVP. A subsequent retrograde cystoureterogram confirmed the hydronephrosis and demonstrated a distal calculus and stenosis, findings which were compatible with retroperitoneal fibrosis (RPF). This diagnosis was confirmed at surgery and the patient's ureters were freed. Following surgery, return of normal kidney function and satisfactory recovery, this aviator returned to full flying duty. A review of RPF is included.
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PMID:Retroperitoneal fibrosis as a cause of hypertension in an aviator: a case report. 844 6

A total of 419 calculi in the upper urinary tract of 402 patients were treated by SWL with the EDAP LT-01 lithotripter from July 1988 to September 1989. Subcapsular hematomas resulted in 17 kidneys of 16 patients, an incidence of 4.1%. On CT scan, fractures with subcapsular hematomas were observed in nine kidneys, and a retroperitoneal hematoma was observed in one patient. There was no significant difference in stone location and size, grade of hydronephrosis, number of shock waves, applied energy, or post-treatment fever between the groups with and without hematomas. However, the hematoma group revealed significantly (P < 0.01) higher incidences of pretreatment hypertension (> 160/95 mm Hg) and use of antiplatelet agents. It is difficult to detect some disorders of blood coagulation in ordinary laboratory studies in patients receiving low dosages of antiplatelet agents; and many drugs including analgesic and anti-inflammatory agents, calcium antagonists, coronary vasodilators, antiplatelet agents, beta-blockers, and lipid-regulating agents have antiplatelet actions. Therefore, particular care should be taken in SWL when a patient is using those drugs.
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PMID:Perirenal hematomas caused by SWL with EDAP LT-01 lithotripter. 848 15

A female patient who had open heart surgery for cor triatriatum under hemodialysis, subsequent kidney transplantation and pregnancy is reported. We performed hemodialysis on the patient before, during and after heart surgery to control renal failure. Two years after heart surgery, she received a kidney graft from her mother. The kidney graft showed good function. She was treated with azathioprine and prednisone. Three years after renal transplantation she delivered a healthy male infant by elective Caesarean section at 37 weeks' gestation. Mother and infant did well following delivery. There was lack of hypertension, proteinuria, signs of graft rejection, and recurrence of heart failure during pregnancy. She showed serum creatinine level < 2 mg/dl, a prednisone of < 2 mg/kg/day. Elective Caesarean section has improved hydronephrosis due to the compression of the fetus. The aforementioned good criteria contributed to the successful pregnancy of the renal transplant patient in our experience. We believe early surgical intervention overcomes complicated heart disease even with endstage renal disease, and it gives a chance to receive renal transplantation and have a healthy child. To our knowledge, this is the first report that has described the successful management of open heart surgery under hemodialysis, subsequent renal transplantation and pregnancy in a female patient with chronic renal failure.
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PMID:A case of cor triatriatum with end-stage renal disease: successful management of open heart surgery under hemodialysis, subsequent renal transplantation and pregnancy. 848 11

Ureteral obstruction due to endometriosis is an infrequent condition which can be asymptomatic for a long time. Irreversible loss of renal function may result in cases with delayed diagnosis. Our report concerns a case of unilateral hydronephrosis and hypertension due to retroperitoneal endometriosis occurring in a 24-year-old woman. The management of patients bearing obstructive uropathy caused by endometriosis is discussed. In the present case, a conservative operation followed by medical treatment, including GnRH analogs, was used to preserve reproductive capacity.
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PMID:Ureteral obstruction due to retroperitoneal endometriosis: a conservative approach including surgery and GnRH analogs. 870 87

Presentation of a case report of a female patient with single right kidney and background of left nephrectomy 21 years earlier due to hypertension who presented to the clinic after an episode of oliguria with lower limbs oedema and renal failure. Renal ultrasound evidenced moderate hydronephrosis, and backward pyelography showed medialization and lumbar ureter compression. CAT examination confirmed the ureteropyelocalycectasis as well as the reduction of the infrarenal lower cava vein to a fibrous cord with internal calcification. Axillary cavography and venography through both femorals demonstrated absence of the infrarenal cava vein segment and existence of a large replacement venous network. During surgery it became evident that the latter was displacing a retrovenous right lumbar ureter medially. Ureterolysis and ureter section with transposition, and termino-terminal anastomosis were performed. The morphological and functional results were excellent with recovery of the renal function (normal serum creatinine) which is still maintained after 7 years follow-up. As a consequence of this case, a review was made of different cava vein anomalies with repercussion in the urine excretory tract.
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PMID:[Ureteral obstruction caused by periureteral venous dilatation secondary to infrarenal caval obstruction]. 876 4

We examined the involvement of the renin-angiotensin system in the maintenance of hypertension of the rat with congenital hydronephrosis having no urinary tract obstruction. The congenital hydronephrosis rat (HNR) had a significantly higher systolic blood pressure (181 +/- 9.5 mm Hg in the male bilateral hydronephrosis rat, BHN, at 13 weeks of age, n = 10) than control Wistar-Imamichi rats (126 +/- 5.8 mm Hg). The plasma renin activity and plasma angiotensin-II concentration of BHN were decreased to 20.1 and 24.6% of those of control rats, respectively. There was a negative correlation between plasma angiotensin-II concentration and blood pressure. In addition, the effect of captopril and indomethacin on the high blood pressure of BHNs was similar to that of human low-renin essential hypertension. These findings suggest that the renin-angiotensin system activity was markedly lowered and that the involvement of the system in the maintenance of hypertension in HNRs is small.
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PMID:Hypertension and the renin-angiotensin system in the congenital hydronephrosis rat with non-obstructive pelviureteric junction abnormalities. 878 2

In general, renal artery aneurysms occur very rarely. This study reports on a 9-cm renal artery aneurysm which was erroneously thought to be a renal cyst, and which, as a result of depression of the renal parenchym and the ureteropelvic junction, led to arterial hypertension and consecutive, reduced function hydronephrosis.
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PMID:A major renal artery aneurysm as the cause of a hydronephrosis with renovascular hypertension. 896 95

The incidence of tuberculosis has risen in many parts of the world, and more attention is being focused on genitourinary tuberculosis (GT), the second most common extrathoracic form of tuberculosis. Although chemotherapy is the mainstay of treatment, ablative surgery as a first-line management may be unavoidable for sepsis or abscesses. In cases with hydronephrosis and progressive renal insufficiency caused by obstruction, renal drainage (by stenting or nephrostomy) must be performed immediately. In all other situations triple-drug chemotherapy should be undertaken for at least 6 months and stable conversion obtained before ablative or reconstructive surgery is planned. Nephrectomy or partial nephrectomy is indicated for nonfunctioning or poorly functioning kidneys, particularly if continuous flank pain or hypertension is present. Stenosis of the ureter usually can be managed by temporary stenting and adjuvant corticosteroid therapy. Today the indications for augmentation are rare, but bladder replacement may be combined with ureter replacement using segments of intestine.
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PMID:Indications for surgical management of genitourinary tuberculosis. 920 38

Acute myocardial infarction after the use of intravenous radiographic contrast medium (RCM) is rare. There is only one reported case in the literature; this is the second case. A 65-year-old woman complained of pain in the right costovertebral area, and abdominal ultrasonography showed hydronephrosis. She had insulin-dependent diabetes and hypertension. Intravenous pyelogram, using renographin, was performed. Within 5 minutes, she felt bad and became hypotensive and diaphoretic. Laboratory studies and electrocardiography confirmed the diagnosis of acute myocardial infarction. Generally, elderly and diabetic patients with abnormal renal function are considered to be at high risk for adverse reactions to RCM. Renal function was normal. It has also been reported that high R osmolality RCM such as renographin, is associated with a greater risk of adverse reactions compared with the use of low-osmolar RCM. This case should raise awareness regarding acute myocardial infarction as a complication after the use of intravenous RCM.
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PMID:Acute myocardial infarction after intravenous radiographic contrast medium. 925 15

Renal ablation by transcatheter renal arterial embolization (TAE) was performed in 10 patients with benign renal disease (hydronephrosis n = 6; renovascular hypertension n = 3; nephrotic syndrome n = 1). Each affected kidney had little or no renal function. Six patients with hydronephrosis were treated with TAE using absolute ethanol alone in three patients and the combination of absolute ethanol and gelatin sponge in the other three. Each patient was followed by sclerotherapy of the pelvocalyceal system via nephrostomy using absolute ethanol. In four of the six patients, the embolized kidney had no urine, and there was very little urine in the remaining two. The size of the embolized kidney was markedly decreased on CT. The three patients with renovascular hypertension were pre-studied by selective and renal vein sampling for PRA, and the kidney excreting higher renin was embolized by TAE with absolute ethanol. Blood pressure has become manageable without antihypertensive drug in two patients and with a reduced amount of drug in one. The patient with nephrotic syndrome had end stage renal failure and showed significant protein excretion. To prevent further protein loss, both kidneys were embolized with stainless steel coils. Urine output was significantly decreased, and consequently, hypoalbuminemia improved. All patients tolerated the procedure well, and there were no significant complications. Renal ablation by TAE may be an alternative to surgical treatment in selected patients with benign renal disease, particularly in patients with contraindications to surgery and in the elderly. Absolute ethanol and gelatin sponge seem safe and effective for TAE in patients with hydronephrosis and renovascular hypertension. For hydronephrosis, we recommend combining TAE with sclerotherapy of the pelvocalyceal system via nephrostomy using absolute ethanol. Though we successfully applied steel coil for the patient with nephrotic syndrome, absolute ethanol may be equally effective.
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PMID:[Renal ablation by transcatheter renal arterial embolization in the treatment of benign renal disease]. 926 Nov 90


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