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

To develop a profile of nonazotemic polycystic kidney disease as it occurs in families, we identified and studied 164 persons with autosomal-dominant polycystic kidney disease, 81 persons suspected of having the disease, and 250 family members without the disease. Because symptoms were absent in 32% of patients with the disease but present in 30% of persons without the disease, symptoms are not reliable in screening for the disease. Hypertension and palpable kidneys and liver were significantly commoner in patients with the disease, but systolic murmur unrelated to hypertension (10.5%) and peripheral edema (9.3%) also were common. Normal laboratory values do not exclude the diagnosis of polycystic kidney disease. Ultrasonography appears to be more sensitive than excretory urography in detecting the disease and also can detect hepatic cysts. Berry aneurysms can occur and are an important cause of mortality and morbidity. The relation of renal cysts to signs, symptoms and renal function is discussed.
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PMID:Polycystic kidney disease: prospective analysis of nonazotemic patients and family members. 674 48

From August, 1981, to August, 1982, the authors performed four-vessel angiography in 17 patients with polycystic kidney disease (PKD) who had no neurological deficit and no history of subarachnoid hemorrhage. Seven cases of unruptured aneurysms were found among these 17 patients (an incidence of 41.2%). Five of the unruptured aneurysms were operated on prophylactically, with no mortality or morbidity. Nine of the 17 patients had hypertension and, of these, two (22.2%) had aneurysms. Of the eight patients without hypertension, five (62.5%) had aneurysms. This study suggests that the coexistence of PKD and intracranial aneurysms might not be due to the hypertension that occurs concomitant with PKD, but instead may be attributable to congenital factors. The authors stress the necessity of early diagnosis and early operation for unruptured aneurysms in patients with PKD.
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PMID:Polycystic kidney disease and intracranial aneurysms. Early angiographic diagnosis and early operation for the unruptured aneurysm. 682 44

Fertility and pregnancy complications were assessed in 137 women at risk of having inherited the gene for autosomal dominant polycystic kidney disease. Seventy-six (55%) of these subjects were found to have polycystic kidney disease (multiple renal cysts). The remaining 61 women served as controls. The prevalence of fertility, spontaneous abortion, stillbirth, and symptoms consistent with urinary tract infection were not different in the two groups. However, the frequency of hypertension first diagnosed during pregnancy (with or without preeclampsia or eclampsia) and the frequency of pregnancy-unrelated hypertension were higher in women with polycystic kidney disease. No evidence was found that pregnancy had an adverse effect on the natural course of polycystic kidney disease. The incidence of renal failure was not higher in women with polycystic kidney disease who had three or more pregnancies than in women of similar ages who had two, one, or no pregnancies.
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PMID:Fertility and pregnancy complications in women with autosomal dominant polycystic kidney disease. 683 10

Transarterial renal embolization has been used in the management of renal cancer. We report on 9 patients who underwent selective and superselective renal arterial embolization for nonmalignant renal lesions. Embolization was done in 5 patients for hemorrhage owing to renal angiomas, renal artery, pseudoaneurysm, percutaneous renal biopsy and adult polycystic kidney disease, and in 2 patients with end stage renal disease because of massive proteinuria. Another chronic renal failure patient with severe hypertension was treated successfully with bilateral renal embolization. A postoperative renal arteriovenous fistula was treated successfully by catheter vaso-occlusion. Renal embolization may be a suitable alternative to surgery in poor operative risk patients and for technically difficult benign lesions. Renal infection is a contraindication to embolization.
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PMID:Percutaneous vaso-occlusion for nonmalignant renal lesions. 684 8

Adult polycystic kidney disease is inherited in an autosomal dominant fashion and it ranks third as the cause of end-stage renal disease, with 9% of patients in dialysis treatment. It is possible to achieve an effective primary or secondary preventive action because of its clinical, evolutive and hereditary features. We studied 134 patients with different degrees of renal function, considering the beginning and the evolution of the disease. The collected data were compared with other reports. Furthermore the finding of cysts in organs other than the kidney, the coexistence of intracranial aneurysms, high blood pressure and pregnancy were examined. We report a study carried out on 17 families of patients in hemodialysis because of MPRA, which included 118 subjects. We were only able to examine 40 adults (34%) completely and among these five patients were discovered to have MPRA. For 29 of the subjects (41%) didn't complete the examinations or refused further investigations. The contemporary presence of suggestive family history and data obtained by urography, nephrotomography, nephrosonography and the study of renal function permit a reliable diagnosis. The incidence of the disease could only be reduced by a constant prevention, but there are considerable difficulties caused by the little attention given to the disease by the medical class and people in general.
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PMID:[Prevention and clinical course of polycystic kidney disease in adults. Examination and case report of 134 patients]. 689 Oct 37

Two cases of simultaneous medullary sponge and adult polycystic kidney disease developed in siblings. The diagnoses of polycystic kidneys were made by renal ultrasonography and medullary sponge kidney was diagnosed roentgenographically. The family history was markedly positive for "cystic" disease. Medullary sponge kidney might be a precursor of polycystic kidney disease in some instances, or, more likely, this represents two separate afflictions occurring in the same individuals. When large medullary sponge kidneys are encountered, the possibility of concomitant polycystic kidney disease should be entertained and investigated with a sonogram. While the prognosis of isolated sponge kidney is excellent, polycystic kidney disease eventually leads to hypertension and renal failure.
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PMID:Simultaneous medullary sponge and adult polycystic kidney disease: the need for accurate diagnosis. 705 19

A cystic renal lesion is described in a girl with oral-facial-digital syndrome, type I. Excretory urography was normal at 1 yr of age; however, flank masses, hypertension, and renal failure were discovered at 11 yr of age. Bilateral nephrectomies were performed prior to renal transplantation. The renal cortex was replaced by large cysts. The cysts were lined by flattened nondescript epithelium and many contained glomerular tufts. Twenty renal cysts were aspirated, and the cyst fluid analyzed for sodium, potassium, creatinine, and osmolality. The concentration of solutes in the cyst fluid was comparable to plasma values. The pathologic features and pattern of cyst solute concentration appear to distinguish the cystic renal lesion in oral-facial-digital syndrome from the more common adult-type polycystic kidney disease.
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PMID:Cystic kidneys in a patient with oral-facial-digital syndrome type I. 707 12

Two brothers with the neonatal presentation of dominant polycystic kidney disease are reported. The first infant died shortly after birth; autopsy revealed polycystic kidneys. The second infant had two markedly enlarged kidneys at birth. Intravenous pyelography at the age of 10 days showed typical images as observed in the recessive form of polycystic kidney disease. Kidney biopsy showed cystic dilation involving all parts of the nephron; the liver biopsy did not show any abnormality. Severe arterial hypertension was a major problem in the first six months of life. At the age of 3 and 5 years, respectively, the patient developed intracerebral hemorrhage, which was due to a complex intracerebral arteriovenous malformation. At the age of 8 years the boy had chronic renal failure and spastic quadriplegia. Previously unsuspected polycystic kidneys were found in the father during the family study.
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PMID:Autosomal dominant polycystic kidney disease in the neonatal period: association with a cerebral arteriovenous malformation. 714 54

A 48 year-old man is presented who died of rupture of intracranial aneurysm. Autopsy findings revealed a ruptured anterior communicating artery aneurysm associated with polycystic kidneys and polycystic liver. Epidermiological review is performed using "Annual of the Pathological Autopsy Case in Japan" (Vol. 17-20). In 92854 autopsy cases, there are 243 cases of polycystic kidney, 1542 cases of intracranial aneurysm and 10 cases of association with both of them. Several points come clear from comparing our data with foreign ones, as follows; 1) The frequency of polycystic kidney (0.25%) is almost the same between Japan and foreign country. 2) The frequency of intracranial aneurysm (1.6%) is higher in Japan. 3) The frequency of association with both (0.01%) is lower in Japan. 4) The frequency of intracranial aneurysm appears to be higher in cases suffered from polycystic kidney than in others. We suspected that cerebral aneurysm formation is caused by hypertension due to polycystic kidney, although in many reports, the association of polycystic kidney and cerebral aneurysm is explained to be maldevelopment. The operation of cerebral aneurysm with polycystic kidney is the same as that without polycystic kidney. But the control of hypertension and renal function is necessary during and after operation.
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PMID:[The association of polycystic kidneys with intracranial aneurysms (author's transl)]. 737 Jan 38

A characteristic cystic renal lesion is described in three infants with tuberous sclerosis. Large cystic kidneys were present at birth in one child. The other two patients were discovered to have cystic kidneys and hypertension at 3 months of age. Development delay and seizures were ultimately present in two infants; typical cutaneous lesions of tuberous sclerosis developed in only one child. The roentgenographic appearance of the kidneys in the two older children was similar to that of adult-type polycystic kidney disease. Cysts were lined by a distinctive, hyperplastic epithelium in each patient. The diagnosis of tuberous sclerosis may be determined by renal biopsy in infants presenting with cystic kidneys.
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PMID:The cystic renal lesion in tuberous sclerosis. 742 Feb 20


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