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

A patient with a single functioning kidney presented with the nephrotic syndrome. On the basis of highly selective proteinuria, a diagnosis was made of lipoid nephrosis. Steroid therapy over a 2-year period did not control the disease. The patient eventually developed end-stage renal failure and malignant hypertension. Nephrectomy was performed to control the hypertension. Histological examination showed congenital dysplasia in one kidney and sclerosing glomerulonephritis, malignant nephrosclerosis, as well as dysplastic changes in the other.
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PMID:Sclerosing glomerulonephritis and malignant hypertension in a patient with congenital renal dysplasia: A case report. 55 Apr 41

Situations requiring immediate lowering of systemic blood pressure are infrequent. Certain clinical syndromes resulting from or complicated by severe hypertension demand vigorous, usually parenteral, antihypertensive therapy. Such syndromes include (1) diastolic hypertension accompanied by sudden disruption of cerebral function, (2) dissecting or leaking aortic aneurysm; (3) accelerated or malignant hypertension, (4) toxemia of pregnancy when either the fetus' or the mother's life is immediately threatened, (5) some instances of diastolic hypertension and acute left ventricular failure, (6) uncontrolled hypertension in the patient who requires emergency surgery, (7) refractory elevation of the diastolic pressure in the kidney transplant patient, and (8) refractory hypertension complicating myocardial infarction or angina. Drugs useful in acutely lowering blood pressure include diazoxide, sodium nitroprusside, methyldopa intravenously, reserpine intramuscularly, and trimethaphan camsylate intravenously. Use of furosemide reinforces the hypotensive effect of these agents. Theoretical advantages and disadvantages of these agents are not always encountered in clinical use.
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PMID:Hypertension crisis. Recognition and management. 57 54

Report on a 10 year-old boy with acute hemiplegia after an ischemic cerebrovascular accident, provoked by an unilateral renovascular disease with malignant hypertension, for which nephrectomy was carried out. The few publications pertinent to cerebrovascular complications in children with hypertension and the value of comprehensive diagnostic operations, are the basic motives for this report.
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PMID:Renovascular hypertension as a cause of cerebrovascular accident in childhood: a case report. 57 1

The morphological picture of bioptic renal tissue was studied in 23 patients with different forms of vasorenal hypertension, among whom 12 had fibromuscular dysplasia of the renal arteries, 8 had atherosclerotic stenosis, and 3 had panarteritis of the aorta and its branches with involvement of the renal arteries. The syndrome of malignant hypertension was encountered in 13 patients and stable arterial hypertension with high blood pressure levels in 10 patients. Analysis of the bioptic material allowed it to be divided into two groups: the 1st was marked by a picture of "Selye's kidney" and the 2nd by a combination of stenosis of the renal arteries and parenchymatous diseases of the kidneys. The significance of examining the morphological picture of renal bioptates, both with regard to the study of the pathogenesis of vasorenal hypertension and the diagnosis of concomitant parenchymatous process is shown.
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PMID:[Value of puncture biopsy of the kidneys on the side of the stenosis in renovascular hypertension. I]. 59 97

A 49 year old black female patient with progressive systemic sclerosis (scleroderma), multiple organ system involvement, uremia and malignant hypertension, was treated with maintenance hemodialysis and bilateral nephrectomy. Bilateral nephrectomy controlled refractory hypertension and appeared to alter the natural course of systemic sclerosis.
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PMID:Scleroderma kidney disease: a therapeutic approach with nephrectomy and hemodialysis. 60 57

A case of accelerated hypertension, which was unique in a resistance to an angiotensin antagonist, and a lack of the elevation of plasma renin activity (PRA) is reported. Non-elevated PRA was coincided with non-malignant nephrosclerosis in renal histology. The acceleration was attributed to the neurological cause i.e., cerebral hemorrhage in the right hypothalamus which extended to the ventricle and subarachnoid space. The case therefore clinically seemed malignant-like, but it was not malignant hypertension in the sense of Volhard's classical definition. This does not conflict with the usefulness of the determination of PRA in the diagnosis of malignant hypertension with nephrosclerosis.
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PMID:An accelerated hypertension with neither malignant nephrosclerosis nor elevation of plasma renin activity. 65 Aug 94

To study whether the renin-angiotensin system is related to hyperuricemia in hypertension, the serum concentration of uric acid was determined in 96 patients with various types of hypertension and various degrees of plasma renin activity (PRA). In malignant hypertension, both PRA and the serum uric acid level were higher than in essential hypertension; but in primary aldosteronism or desoxycorticosterone-excess hypertension, they were lower than in the essential type. In renovascular hypertension, PRA was higher than in essential hypertension, but the serum uric acid levels were similar. There were no differences in PRA and serum uric acid concentration between Cushing's syndrome and essential hypertension. The serum uric acid level in high-renin essential hypertension was higher than in either the normal-renin or the low-renin type. There was a significant correlation between serum uric acid concentration and PRA in the basal state, and between the change in PRA and the change in serum uric acid induced by administration of furosemide. Apparently the close correlation between the renin-angiotensin system and the concentration of serum uric acid is related to changes in extracellular fluid volume, although an intrarenal effect of angiotensin II cannot be excluded.
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PMID:Serum uric acid and the renin-angiotensin system in hypertension. 65 66

Hypertension is a frequent complication of reflux nephropathy. The cause of this hypertension is unknown. Our study was undertaken to assess the possible role of the renin-angiotensin system in the hypertension associated with unilateral reflux nephropathy. We selected for study 17 normotensive and 12 hypertensive patients with strictly unilateral reflux nephropathy. There were 3 normotensive and 2 hypertensive patients with a renal vein renin ratio exceeding 1.5. Of these 3 normotensive patients 1 had evidence from divided renal function studies to suggest functional renal ischemia. No consistent evidence was obtained to support the concept that the renin-angiotensin system has a primary role in the non-malignant hypertension of unilateral reflux nephropathy.
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PMID:Renal vein renin concentration in the hypertension of unilateral reflux nephropathy. 67 98

Acute hypertension leads to alternating regions of dilation and vasoconstriction of surface cerebral vessels. It remains to be determined conclusively if either or both of those calibre changes are essential in the production of degenerative vascular changes of malignant hypertension. There is no evidence of ischemic or other morphologic change to components of the blood-brain barrier including the interendothelial tight junctions which remain intact. An early phase of evolving cerebral edema is swelling of astrocytic foot processes that occurs only in regions of abnormal protein permeability. The cortical location of these acute hypertensive lesions stands in contrast to the ganglionic location of the microaneurysms found as complication of chronic hypertension in man. The location of permeability changes to protein do not necessarily reflect changes in brain water permeability susceptible to sympathetic regulation.
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PMID:Hypertension and the blood-brain barrier. 67 98

Bilateral arteriovenous fistulas secondary to percutaneous needle biopsy of each kidney developed in a patient with malignant hypertension and chronic failure. The fistulas with aneurysmal formation and hematuria were of such magnitude that bilateral nephrectomy was required for control. The patient is now normotensive and is maintained on hemodialysis. The advisability of renal needle biopsy in uncontrolled hypertension is questioned. Cases of intrarenal arteriovenous fistulas resulting from percutaneous needle biopsy of the kidney are being reported with increasing frequency. The exact incidence of fistula formation after kidney biopsy is unknown, but several series based on arteriographic studies show an incidence as high as 18 per cent. Although many of these fistulas disappear spontaneously, approximately 4 per cent persist. A review of the literature failed to reveal the incidence of aneurysmal formation. Our case was complicated by formation of bilateral renal arteriovenous fistulas secondary to repeat bilateral percutaneous needle biopsy and right open renal biopsy. Subsequent gross hematuria from the right ureteral orifice also resulted which was proved by cystoscopy and required replacement with several units of blood. The likelihood of rupture led to bilateral nephrectomy.
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PMID:Iatrogenic renal vascular injury. 70 25


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