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

To assess the activity of lupus nephritis, 43 patients with systemic lupus erythematosus (SLE) were studied by gallium imaging. Delayed renal visualization 48 hours after the gallium injection, a positive result, was noted in 25 of 48 scans. Active renal disease was defined by the presence of hematuria, pyuria (10 or more red blood cells or white blood cells per high-power field), proteinuria (1 g or more per 24 hours), a rising serum creatinine level, or a recent biopsy specimen showing proliferative and/or necrotizing lesions involving more than 20 percent of glomeruli. Renal disease was active in 18 instances, inactive in 23, and undetermined in seven (a total of 48 scans). Sixteen of the 18 scans (89 percent) in patients with active renal disease showed positive findings, as compared with only four of 23 scans (17 percent) in patients with inactive renal disease (p less than 0.001). Patients with positive scanning results had a higher rate of hypertension (p = 0.02), nephrotic proteinuria (p = 0.01), and progressive renal failure (p = 0.02). Mild mesangial nephritis (World Health Organization classes I and II) was noted only in the patients with negative scanning results (p = 0.02) who, however, showed a higher incidence of severe extrarenal SLE (p = 0.04). It is concluded that gallium imaging is a useful tool in evaluating the activity of lupus nephritis.
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PMID:Appraisal of lupus nephritis by renal imaging with gallium-67. 387 88

Unilateral parenchymatous kidney disease associated with high blood pressure represents a potentially curable form of hypertension. Surgery may normalize blood pressure in a substantial number of these patients. Curable renal parenchymatous hypertension includes unilateral tubulointerstitial kidney diseases such as chronic pyelonephritis, reflux nephropathy, segmental hypoplasia and radiation nephritis, hydronephrosis, simple renal cysts, traumatic kidney lesions and renal tumors associated with high blood pressure. Renal ischemia and in turn activation of the renin angiotensin system is involved in the pathogenesis of hypertension in most of these patients. In patients with unilateral kidney disease and hypertension, both an operative and a medical therapeutic approach have a high success rate. Good candidates for nephrectomy are young patients with severe hypertension, strict unilateral disease, normal plasma creatinine levels and minimal function of the involved kidney. In unilateral hydronephrosis reconstructive surgery or nephrectomy may cure or improve hypertension in the vast majority of the patients. Surgically correctable hypertension has also been reported in some patients with large renal cysts and renal tumors (hemangiopericytoma, Wilm's tumor, hypernephroma, renal pelvic tumor).
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PMID:Curable renal parenchymatous hypertension: current diagnosis and management. 390 29

Hypertension has been shown to accelerate the course of experimental nephritis. On the other hand, Heymann nephritic rats undergoing long-term DOCA-NaCl treatment develop hypertension with a malignant course. The present study examined the effect of a short-term DOCA-NaCl load on the development of hypertension and progression of nephritis. Heymann nephritic rats were treated with DOCA-NaCl between weeks 2 and 6 after the first immunization with brush border antigen. Within six weeks, hypertension developed in Heymann nephritis-DOCA-NaCl rats but not in Heymann nephritic rats without DOCA-NaCl treatment whereas DOCA-NaCl-treated rats developed a moderate elevation of blood pressure. During that time, anti-brush border antibodies and immune deposits typical of membranous nephropathy ensued, preceding appearance of proteinuria or histopathologically detectable renal changes in the immunized rats. After discontinuation of DOCA-NaCl treatments at week 6, blood pressure nearly normalized in DOCA-NaCl-treated rats. Within one year, however, blood pressure rose most markedly in nephritic rats treated initially with DOCA-NaCl. The rise in blood pressure at that time correlated with glomerular sclerosis, tubulo-interstitial changes and proteinuria. It is concluded that, during acute nephritis, immunological and hypertensinogenic mechanisms interact, leading to hypertension and aggravated course of nephritis. These experimental observations on nephritis-associated hypertension may have important bearings on human hypertension as well.
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PMID:Hypertension and progression of experimental nephritis. Interaction between immunological and haemodynamic factors. 391 83

Using photography of the fundus oculi the eyeground of 186 patients with histologically different forms of nephritis, 68 patients with essential hypertension and 10 patients with renovascular hypertension was investigated and evaluated. The fundal lesions were classified according to the grades recommended by WHO. Although in many individual cases the duration of the disease was short and the patients were young, the eyeground changes in renal hypertension were notably severe. Taking as basis comparable pressure rises, marked signs of fundus hypertonicus malignus were particularly frequent in primary and secondary hypertension with focal segmental sclerosis and membranoproliferative glomerulonephritis, whereas in essential hypertension non-malignant fundus hypertonicus predominated. The eyeground findings deteriorated further with impairment of renal function. Owing to the high incidence of severe fundal lesions in renal hypertension the eyeground of these patients should be examined and the hypertension treated accordingly even when the rise in blood pressure is relatively mild (less than 180/100 mm Hg).
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PMID:[Fundus hypertonicus malignus. Increased incidence in renal parenchymal diseases]. 394 2

The clinical and histological features of 151 patient with IgA nephritis were analyzed to determine the prognostic features of the disease. The mean duration of follow up examinations was 50 +/- 34 months (range 6 to 168 months). The majority of the patients were young males and showed no signs of IgA nephritis. The disease was detected by routine screening before induction into national service. The plot of the reciprocals of serum creatinine against time in the patients with progressive disease showed that the patients ran two different courses when they developed renal impairment; one was a slow progressive course over an average of 7.7 years before reaching end stage renal failure (ESRF), while the other was a more rapid decline to ESRF within an average of 3.3 years in which severe uncontrolled hypertension seemed to be the major adverse factor. Hypertension was present in 23% of patients. Nine percent had renal impairment at the end of the follow up period while 5% progressed to ESRF. The cumulative renal survival was 91% after 6 years with no further development of renal failure up to 14 years. Unfavorable long term prognostic indices were proteinuria of more than 2 gm, hypertension and presence of crescents on renal biopsy.
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PMID:The natural history of IgA nephritis in Singapore. 395 4

Information on whether a woman had ever had any children was recorded for all deaths registered to ever-married women in England and Wales between 1938 and 1960. Analysis of the relation between parity and cause of death for 1.2 million women aged 45-74 years revealed that parous women had lower mortality from breast, ovarian, and endometrial cancer than did nulliparous women but a higher mortality from diabetes mellitus, gallbladder disease, cancer of the uterine cervix, nephritis and nephrosis, hypertension, ischaemic and degenerative heart disease, cerebrovascular disease, and all causes of death. There is a parallel between the long term effects of pregnancy and of oral contraceptives on health.
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PMID:Long term effects of childbearing on health. 408 66

In an ongoing study of streptococcal skin infection and acute glomerulonephritis (AGN) begun in 1964, C'3 determinations were done in 784 patients. There were 126 patients with acute poststreptococcal nephritis, 172 of their siblings, and 486 patients with uncomplicated impetigo from families without an index case of nephritis.90% of the patients with nephritis were infected with one of the four prevalent streptococcal serotypes associated with nephritis in this population; only 12% of patients with uncomplicated impetigo were infected with similar serotypes.93% of the patients with overt nephritis had diminished complement levels. Low complement was more often observed (8%) in AGN siblings than was transient hypertension and/or hematuria (5%). Considering the relationship of low C'3 alone and low C'3 preceded hematuria in four others. Two (0.4%) of the patients with uncomplicated impetigo had low complement values, both of whom were infected with nephritogenic strains. Transient hematuria and/or hypertension was less frequently observed (2.7%) among patients with uncomplicated impetigo. Serial determinations in patients with low complement revealed a return to normal in a linear fashion within 2-12 wk. The validity of the hypothesis that the asymptomatic patients with low complement levels, with or without hematuria, likely had subclinical nephritis is strengthened by the accompanying epidemiologic data. The finding of low complement before the onset of, or in the absence of, hematuria or other evidence of nephritis supports the concept that an immunologic mechanism may precipitate the renal injury of acute streptococcal nephritis.
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PMID:Complement in overt and asymptomatic nephritis after skin infection. 542 20

Authors review their own experience in PAN, Lupus ery thematosus and renal Amyloidosis. Two patients with PAN, both with arterial hypertension: one of them of macrosco pic type, presenting great aneurysms localized in brain and in renal arteries; the other patient had microscopic type, with good response to corticotherapy after three years of follow-up. Four patients with lupus erythematosus nephritis; kidney biopsy was performed in three of them: two cases with membranoproliferative glomerulonephritis, and the last one with extramembranos glomerulonephritis. All of them had nephrotic syndrome, and arterial hypertension. Seven patients with renal amyloidosis, four related to reumatoid artritis, two related to mucoviscidosis and the las case was a patient with recurrent mediterranean fever.
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PMID:[Collagenosis nephropathies]. 611 54

Nifedipine, a calcium antagonist, was administered intravenously (13.3 micrograms/min) for 45 min, and the changes in blood pressure, glomerular filtration rate (GFR), renal blood flow (RBF), total renal resistance, urinary volume, urinary sodium and potassium excretion, plasma renin activity, and plasma aldosterone concentration were studied. GFR and RBF were measured by intravenous infusion of sodium thiosulfate and sodium para-aminohippurate, respectively. The subjects included 12 cases of essential hypertension, nine of chronic glomerular nephritis with hypertension, 14 of chronic glomerular nephritis without hypertension, and 12 normotensive controls. In patients with essential hypertension, GFR and RBF increased markedly (by 45.6% and 44.8%, respectively), but in normotensive and hypertensive patients with chronic glomerular nephritis, these indices did not change significantly. The urinary volume and urinary sodium excretion increased in all groups. The natriuresis induced by nifedipine is probably due to the increase of GFR and RBF. The results of this study suggest a difference in renal vascular pathophysiology between essential hypertension and chronic glomerular nephritis. The results also suggest a functional change of the renal vascular system in essential hypertension, i.e., the increased vascular tone and the particular sensitivity of renal arterioles to nifedipine.
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PMID:Clinical effects of intravenous nifedipine on renal function. 618 62

Five patients aged 1.1 - 4.3 years, affected by nephritis secondary to infection of ventriculo-atrial shunt are presented. The time lag between the occurrence of shunt infection and diagnosis of nephropathy varied from 1 to 12 months. In four patients "Staphylococcus epidermidis" was isolated from blood and CSF cultures, and "Staphylococcus aureus" in another one. Renal lesion presented as hematuria and proteinuria, and two patients developed a nephrotic syndrome. Hypertension was present in three patients. C'2 and D'4 hypocomplementemia was a constant feature in the acute stage of the disease. Endocapillary glomerulonephritis was observed in three patients and endo-extracapillary glomerulonephritis in one (70% of crescent formations). After shunt removal and antibiotic administration a favorable clinical course was followed in three patients, with remission of nephropathy signs. The fifth patient (non biopsied) died in the course of a septic process, having kept until then a good renal function.
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PMID:[Shunt nephritis (author's transl)]. 621 Nov 17


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