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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Simple renal cysts are increasingly common with increasing age, as is elevated arterial blood pressure. We studied the natural history of simple renal cysts, and their possible association with arterial hypertension. Renal sonography was performed in an age- and sex-stratified random sample of 686 healthy volunteers aged 30-70 years. Eleven examinations were excluded for various reasons. One or more renal cysts measuring 10-47 mm were found in 35 individuals. The prevalence of simple renal cysts was 5.2%, ranging from 0% at age 30 to 9.7% at age 70. From the cross-sectional data it is estimated that the average renal cyst needs about 10 years to reach 20 mm in size. Mean arterial blood pressure increased with age, and was significantly higher in individuals with cysts (p = 0.0055). Closer analysis showed that the association was confined to and even stronger (p = 0.00066) for individuals with at least one cyst < or = 20 mm. We assume that smaller cysts are more likely to be totally intraparenchymal, and therefore more able to create an internal hydrostatic pressure and thus to compress the surrounding renal tissue.
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PMID:Simple renal cyst: relations to age and arterial blood pressure. 837 20

To reduce renal cyst size in autosomal dominant polycystic kidney disease (ADPKD), minocycline hydrochloride solution was instilled into the enlarged cysts in three ADPKD patients. In one patient with reduced renal function, such sclerotherapy apparently diminished cyst size, but without apparent improving effect on renal function at 7 months of follow-up. The second patient, who needed the replacement therapy on admission, had been free from hemodialysis over 4 months after the therapy. Persistent flank pain disappeared in both patients. In the third patient with normal renal function, sclerotherapy was done to get a better control of hypertension. Initially blood pressure decreased, but it returned up to the pre-therapy level irrespective of definite reduction of the enlarged cysts at 8 months of follow-up. The therapy with minocycline hydrochloride did not appear harmful, and may be helpful in the management of ADPKD.
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PMID:Effects of topical instillation of minocycline hydrochloride on cyst size and renal function in polycystic kidney disease. 846 1

Benign renal cysts are usually asymptomatic: They require a minimally invasive treatment if they cause complaints such as flank pain or other compressive complications. During a 6 month period, 14 patients were treated for benign renal cyst using an ultrasound guided puncture. Presenting complaints were flank pain (12 cases), hypertension (1 case), polycythaemia (1 case). Only cyst of 5 centimeters diameter or more were assigned to this treatment. After needle puncture, the cyst was evacuated and then filled with sterile 95% alcohol. Clinical and anatomical results, after 6 months, were good in 9 cases, 2 cases showed good anatomical results with persistence of initial symptoms, and there were 3 failures corresponding to large cysts of 10 cm diameter or more. Percutaneous alcoholization of moderate benign cysts is a safe, simple and reliable method.
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PMID:[Percutaneous alcoholization of simple serous cysts of the kidney]. 863 8

Adult polycystic kidney disease (APKD) is a common genetic disease and one of the important reasons of end stage renal failure. Although renal multiple cysts are clearly an important manifestation of APKD; other systemic manifestations are both common and clinically important. The authors reviewed 205 cases from 180 APKD families (107 male 98 female). Their age ranged from 10 to 71 years. Renal cyst is one of the many renal manifestations. Hypertension, hematuria and flank pain are its major complications. Hepatic cysts, pancreatic cysts, cardiac valvular lesions, intracranial aneurysms and splenic cysts are included in the array of systemic manifestations.
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PMID:[Systemic manifestations of adult polycystic kidney disease: an analysis of 205 cases]. 869 29

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

Management of unilateral multicystic dysplastic kidneys (MCDK) presents physicians and surgeons with a significant dilemma. Recent studies have indicated that the incidence of short term complications of MCDK is low and many authors have recommended conservative non-operative treatment. Surgery has been proposed by some because of the potential complications of hypertension, infection, and malignant change. Three children with hypertension secondary to MCDK seen at this institution in the past four years, one of whom had been discharged from follow up as a result of 'disappearance' of the cystic kidney on ultrasound examination, are reported. We believe that the risks of hypertension secondary to MCDK have been understated, and that based on the conclusions of these studies, many children may be receiving suboptimal follow up. We currently favour elective nephrectomy as the treatment of choice for this lesion.
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PMID:Unilateral multicystic dysplastic kidney: the case for nephrectomy. 938 50

In this review, the recent literature pertaining to the nephrology of the fetus and neonate is reviewed. Some papers of interest are described, and an overview of active areas of research is given. One of these areas is early development, studies of which are giving new insight into patterns of normal and abnormal kidney morphogenesis. Preterm newborn infants may suffer from electrolyte imbalance and poor growth as a result of tubular dysfunction, and this subject is discussed. Also addressed are some advances in genetics that are elucidating the genetic defects of cystic kidney diseases and providing clues about the pathogenesis of renal dysplasia. Other areas discussed in this review are the assessment of renal function in the fetus and neonate, blood pressure and hypertension in the neonate, renal failure in the term and preterm infant, and the causes and the consequences of fetal urinary obstruction.
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PMID:Fetal and neonatal nephrology. 920 42

Among all inherited cystic kidney diseases, the commonest are polycystic kidney diseases, which include 2 diseases characterized by their pathological characteristics and their mode of inheritance, namely autosomal dominant or recessive. Autosomal dominant polycystic kidney disease is usually diagnosed in adulthood and is related at least to 2 different genes; PKD1 gene on chromosome 16 accounts for 85% of cases. This frequent disease (1 in 1,000 people) leads to end-stage renal failure in most patients at a mean age of 55 years. Renal ultrasonography allows its detection at an early stage, during childhood or adolescence, and even in utero in some cases. Autosomal recessive polycystic kidney disease, related to a single gene mapped to chromosome 6, is a rare disease, usually diagnosed during infancy because of enlarged kidneys and hypertension. The early occurrence of advanced renal failure is uncommon and only 1/3 of patients require renal replacement therapy during childhood. The term "polycystic kidney disease" should be limited to these 2 diseases; however there are many other inherited conditions including renal cysts like tuberous sclerosis or Hippel-Lindau's disease in adults, and several malformative syndromes in children.
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PMID:[Cystic kidney diseases]. 936 10

Branching tubulogenesis of the ureteric bud is critically important for kidney development. Recent findings using three-dimensional cell culture systems for in vitro branching tubulogenesis are likely to shed light on the mechanisms of ureteric bud morphogenesis. Here, we try to unify these findings with those obtained using genetic approaches and organ culture of the embryonic kidney into a working model of ureteric bud branching tubulogenesis. It appears that the balance between branching tubulogenesis facilitating growth factors such as epidermal growth factor receptor ligands, hepatocyte growth factor, insulin-like growth factors, and inhibitory growth factors such as transforming growth factor beta family members may regulate branching morphogenesis. Growth factors induce epithelial cell proliferation, migration, and modulate the expression of a variety of proteins. Downstream in the growth factor-mediated tubulogenesis pathway, extracellular proteases, protease inhibitors, extracellular matrix proteins, and integrins are likely to act as effectors and regulators of branching tubulogenesis. Discussed in some detail are the relevance of insights gleaned from in vitro models of branching tubulogenesis to congenital urogenital abnormalities, cystic kidney diseases, oligonephropathies and hypertension, tubular cell regeneration after injury, and tubular engineering.
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PMID:In vitro branching tubulogenesis: implications for developmental and cystic disorders, nephron number, renal repair, and nephron engineering. 964 59

During the last few years there has been a renewed interest in blood-pressure-induced kidney damage, due to a progressive increase in the incidence and prevalence of hyipertension and vascular diseases as a cause of end-stage renal disease (ESRD). The need to prevent ESRD demands continued efforts to achieve the early identification of persons with hypertension who are at risk and to provide them with effective antihypertensive therapy. Ambulatory blood pressure monitoring (ABPM) has been used successfully to assess blood pressure values and identify risk markers for cardiovascular diseases. A logical approach would be to use it also to identify those for ESRD. For hypertensive and type 1 diabetics ABPM data usually have a stronger correlation to the presence and magnitude of microalbuminuria than do routine office blood pressure measurements. The best Pearson correlation coefficients for relationship between ambulatory blood pressure values and urinary excretion of albumin were obtained with nocturnal blood pressure regardless of whether systolic, diastolic or mean blood pressure were considered. Moreover, high percentages of non-dippers have been found among subjects with renal failure, subjects undergoing dialysis (haemofiltration, peritoneal dialysis, continuous ambulatory peritoneal dialysis (CAPD), subjects with renovascular hypertension and with cystic kidney disease, subjects who have had a kidney transplant and subjects with cyclosporine-induced hypertension. Finally, ABPM seems to be prognostic for development of proteinuria in some refractory hypertensives. Whether higher nocturnal blood pressure values and the non-dipping pattern constitute a cause or are consequences of renal disease should be addressed in prospective studies. Assessment of nocturnal blood pressure seems to be an important tool in the management of patients with hypertensive-related renal disease and of patients who are susceptible to developing it.
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PMID:Ambulatory blood pressure and the kidney. 1021 47


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