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)

Of 27 children who underwent surgical treatment for renovascular hypertension 16 (59 per cent) were cured, 5 (19 per cent) were improved and 6 (22 per cent) were failures. Improved results were obtained in patients with unilateral renal artery stenosis. Several reconstructive vascular procedures were used, and their relative efficacy and indications are discussed. Renovascular hypertension in children is a curable disease and revascularization with preservation of renal parenchyma should be the aim of surgical therapy in most cases.
 ...
PMID:Surgical treatment of renovascular hypertension in the pediatric patient. 66 Jul 66

From 1955 to 1977, 27 pediatric patients underwent surgical treatment for renovascular hypertension. Renal artery disease was most commonly caused by intimal or perimedial fibroplasia and occurred bilaterally in 7 patients. Overall results were 16 patients cured (59%), 5 patients improved (19%) and 6 failures (22%). The best results were obtained in children with unilateral renal artery stenosis. In recent years, ablative surgery has been largely supplanted by reconstructive vascular procedures in the treatment of this disease in children. Autogenous vascular bypass grafts have been most successful and aortorenal reimplantation may occasionally be employed. Renal autotransplantation should be reserved for children with the middle aortic syndrome or multiple lesions involving the branches of the renal artery. Splenorenal bypass and segmental resection with renastomosis have yielded poor results and are best avoided in this age group. Primary nephrectomy should only be performed in patients with renal atrophy or uncorrectable branch vessel disease. Renovascular hypertension in children is a potentially curable disease and revascularization with preservation of renal function should be the combined objectives of surgical therapy in the most cases.
 ...
PMID:Stenosing renal artery disease in children: clinicopathologic correlation and results of surgical treatment. 74 36

Renovascular hypertension is the most prevalent form of surgically remediable hypertension. With appropriate selection of operative candidates, a high rate of cure or improvement may be anticipated. Favorable results justify revascularization in hypertensive patients with focal arteriosclerotic renal artery disease. The absence of advanced arteriosclerosis provides the most valid basis for predicting long-term survival following revascularization. Patients with clinically demonstrable diffuse arteriosclerotic disease are preferably treated medically; we consider them candidates for surgery only if drug therapy cannot control blood pressure. Renal revascularization does not appear to alter the inexorable progression of concomitant generalized arteriosclerosis. Revascularization rather than nephrectomy is the primary surgical therapy for renal artery stenosis in properly selected patients.
 ...
PMID:Detecting and treating arteriosclerotic renovascular hypertension. 78 Feb 1

Renovascular hypertension developed in an anephric 37-year-old patient after he received a cadaveric renal transplant from a 2-year-old donor. Despite adequate homograft function, a transplant nephrectomy was perfomed because of intractable, lifethreatening hypertension. There was relative stenosis throughout the course of the transplanted renal artery. Pathologic examination of the kidney did not demonstrate evidence of technical failure or immunological or hypertensive damage. Atrophic changes in the media of the renal artery may have resulted from radiation damage. The hypertension appears to have been caused by disproportionate growth between the parenchyma in the hypertrophying pediatric homograft and its renal artery.
 ...
PMID:Intractable renovascular hypertension in an adult recipient of a pediatric cadaveric renal transplant. 78 46

Renovascular hypertension in two sisters, aged 22 and 20, respectively, has been described. Renal artery stenoses were observed unilaterally in the elder patient and bilaterally in the younger one. In both patients, the functional significance of unilateral stenosis of the renal artery was documented by the renal vein renin ratio between the affected side and the contralateral or less affected side. High blood pressure and elevated plasma renin activity have been normalized with a unilateral revascularization in the elder patient, and with the treatment of propranolol in the younger one. The histological examination of the stenotic renal artery in the elder patient showed a finding comparable to the perimedial fibroplasia in Harrison and McCormack's classification of idiopathic fibromuscular stenosis.
 ...
PMID:Occurrence of renovascular hypertension in two sisters. 95 Oct 17

Renovascular hypertension caused by renal artery stenosis was a coincidental discovery in 5 of the 6 patients presented. They did not have any comlaint and it was by routine bloodpressure measurement that hypertension was diagnosed. In one patient without hypertension stenosis of both renal arteries was seen on the aortography for an infrarenal aortic occlusion. Depending on the extent and localisation of the stenosis unilateral renal artery stenosis was treated by a saphenous vein graft interposition, or by an aortorenal vein patch. In a man with bilateral renal artery stenosis a venous bridge was constructed. Once an unilateral nephrectomy was necessary, the kidney being atrophic and a vascular correction impossible.
 ...
PMID:Renal artery stenosis and occlusion. 101 82

Renovascular hypertension was diagnosed in a 20-year-old man as being due to bilateral renal-artery stenoses and infrarenal aortic coarctation. Reconstruction of the renal arterial supply by vein graft and aortorenal bypass failed to reduce the hypertension. But after bilateral autotransplantation of the kidneys into the iliac fossa and a dacron lay-on graft over the coarcted region the arterial blood pressure returned to normal. Pre-operative measurement of plasma-renin concentration in renal vein blood and the patient's age are essential factors in deciding on reconstructive surgery of a stenosed renal artery.
 ...
PMID:[Autologous renal transplantation for renovascular hypertension (author's transl)]. 109 31

Renovascular hypertension, comprising a small percentage of the total hypertensive population, stands out as remarkably important, being the most common cause of surgically correctable hypertension. Its precise diagnosis can be accomplished by judicious application of recently available sophisticated laboratory methods and correct prediction of curability is now possible. Careful selection of cases among the vast numbers of hypertensives by routine screening procedures is essential. The selected few deserve more complete studies including bilateral renal vein renin measurements. Rapid sequence pyelography, split function studies, radioisotope renorgram, and renal arteriography accurately define the presence of a significant structural abnormality involving the renal circulation on either side. Significant bilateral renal vein plasma renin differential, done under appropriate conditions of volume depletion and upright posture, in the absence of interference by concurrent antihypertensive drug therapy, establishes a causal relationship between the structural abnormality and the high blood pressure. A thorough knowledge of the normal physiology of the renin-angiotensin-aldosterone system and its inappropriate response in renovascular hypertension and other related clinical conditions is clearly necessary if one is to plan diagnostic studies intelligently and interpret the results correctly.
 ...
PMID:The pathophysiology of renovascular hypertension. 109 52

We have reported on 10 infants less than 3 months old with hypertension. Renovascular hypertension was identified in 80 per cent of these patients. Spontaneous recovery with medical management occurred in 30 per cent of the patients and 57 per cent treated medically died. Of the 3 patients treated by nephrectomy normotensive survival resulted in 2.
 ...
PMID:Hypertension in infancy: the case for aggressive management. 111 32

Certain common but seldom recognized clinical features of renovascular hypertension peculiar to infancy are emphasized in this communication from the observations made in a 9-month-old infant. Failure to thrive, extreme irritability, hypotonia, anorexia, vomiting, diarrhea, respiratory distress, and congestive heart failure are common clinical findings. Unless the physician is aware of this symptomatology or blood pressure is routinely obtained in all infants, the condition is likely to be missed. Renovascular hypertension is malignant and carries a high mortality but if diagnosed early may be cured by surgical intervention.
 ...
PMID:Clinical features of renovascular hypertension in infancy: report of a 9-month-old infant. 115 42


1 2 3 4 5 6 7 8 9 10 Next >>