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)

The mechanisms involved in residual or recurrent hypertension following operation to correct renal artery stenosis were studied in 10 patients by performing angiotensin II blockade with Saralasin (Sarcosine, alanine, angiotensin II) before and after operation. Peripheral renin and renal vein renin determinations, angiography, and renography were done as well. The limitations of renin determinations are cited and the application of angiotensin II blockade as a specific method of detecting renin-dependent hypertension before and after operation are presented. Saralasin infusion under the controlled conditions of our study proved to be a sensitive method for detection of renin-dependent hypertension. The results of Saralasin infusion correlated closely with peripheral and renal vein renin determinations. Thus angiotensin II blockade before and after operation may supercede more invasive and less specific diagnostic methods.
 ...
PMID:Evaluation of surgical response in renovascular hypertension using angiotensin II blockade. 71 82

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

The renal arteriogram is a highly reliable test in the differential diagnosis of early transplant anuria, graft rejection, and hypertension. The reliability of the renal arteriogram was 97.8% in either substantiating or disproving the presence of a suspected episode of graft rejection or renal artery stenosis. The earliest signs of acute humoral and acute rejection were a prolongation of arterial clearance time, diffuse edema with enlargement of the kidney, and progressive deterioration of the nephrogram. Renal artery stenosis may be a sharply localized septum or an elongated narrowing at or distal to the actual site of anastomosis. This was seen primarily in patients' arteriograms more than 60 days after transplantation, and it is important because it is a surgically correctable cause of hypertension.
 ...
PMID:The angiographic evaluation of human renal allotransplants. Functional graft deterioration and hypertension. 76 29

The incidence of hypertension defined as a mean diastolic pressure above 90 mmHg has been evaluated in 85 transplanted patients with a follow-up ranging from 3 to 78 months. The proportion of hypertensive patients rises during the first three months and stabilises subsequently around 60 percent. Over the years hypertension fluctuates so that one-third of the initially hypertensive patients become normotensive, whereas one-third of the initially normotensive patients become hypertensive. The main single aetiological factor is renal failure. No clear relationship was found between prednisolone dosage and hypertension. Renal artery stenosis was found in 2.4 percent of the cases. Finally no single aetiological factor was found in one third of the hypertensive patients. It is speculated that in some of them, minute intrarenal vascular lesions are responsible for the hypertension and lead ultimately to decreased renal function.
 ...
PMID:Hypertension after renal transplantation. 77 38

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

Renal artery stenosis causing hypertension has been noted in 11 patients after successful renal transplantations. We believe that all patients with moderate to severe post-transplant hypertension should be evaluated with angiography and selective renin determinations. However, because of definite risk to the graft we believe that operative intervention should be undertaken only if hypertension is uncontrolled or if declining renal function is present and attributable to the stenosis.
 ...
PMID:Diagnosis and management of arterial stenosis causing hypertension after successful renal transplantation. 78 8

Plasma renin activity (PRA) was measured in nine renal transplant recipients, seven of which had transplant renal artery stenosis. Surgical correction of the stenosed renal transplant artery was performed in six patients. After corrective surgery of the stenosed artery hypertension (mean arterial pressure before operation 156 mmHg) improved (mean arterial pressure postoperatively 110 mmHg) in four patients with high peripheral PRA (17.3+/-3.9 ng/ml. hr). Two patients, one hypertensive, the other normotensive with low PRA (1.5+/-0.05 ng/ml. hr) had no change in their blood pressure after corrective surgery. In three hypertensive renal transplant recipients the PRA of the venous effluent of the own kidneys and the renal transplant were studied selectively. Selective PRA determinations revealed the source of inappropriate renin secretion offering a basis for surgical management of the assocaited hypertension.
 ...
PMID:Plasma renin activity in the evaluation of hypertension in renal transplant recipients. 78 11

Investigation in a patient aged 46 years with decompensated heart failure and severe renal insufficiency demonstrated a small, poorly functioning right kidney and severe stenosis of the left renal artery. Cardiac decompensation was corrected and the left kidney revascularised by autotransplantation. Renal function recovered considerably (FG 75/min) and the severe hypertension was reduced. In hypertension patients by main renal artery stenosis, renal autotransplantation is recommended, since it is a safe method without technical difficulty and has given good results. The mutual dependence of hypertension and renal insufficiency is reviewed. When renal function is poor, revascularisation of the stenosed kidney will lead to recovery. The hypertension will usually improve but will always become more responsive to drug therapy.
 ...
PMID:Severe renal insufficiency and renovascular hypertension. 78 49

To date angiography has been the most precise diagnostic modality for the evaluation of a transplanted kidney. In the immediate postoperative period angiography can clearly demonstrate the integrity of the vascular anastomoses, and in most cases helps to differentiate between acute tubular necrosis and acute rejection. It is also helpful in the evaluation of the transplant kidney later in the postoperative period, since it can provide some estimate of the vascular effects of chronic rejection and distinguish between hypertension secondary to chronic rejection or renal artery stenosis. Serial isotope techniques may play a more important role in the evaluation of the transplanted kidney in the future, but at present angiography is the diagnostic modality of choice at the Cleveland Clinic.
 ...
PMID:Selective renal angiography: its value in renal transplantation. 79 Jul 34

In Europe, about 1% of the women using oral contraceptives develop hypertension. Predisposing factors seem to be age, hypertension problems in past pregnancies, family history of hypertension, personal histories of kidney disorders, diabetes mellitus or adipositas, or diastolic pressure over 80 mm Hg. An overactive renin-angiotensin-aldosterone system may be an important factor in the etiology of this type of hypertension. Oterh possible factors are: reduced excretion of angiotensin 2, increased sensitivity of the arterioles to substances such as angiotensin 2 and noradrenaline, direct effect of ethinyl estradiol and mestranol on the sodium and water system, cardiovascular changes, disorders in the adrenergic system (e.g., catecholamine metabolism). Blood pressure should be checked before beginning any treatment with oral contraceptives and every 3 months after that. For the purpose of differential diagnosis angiotensin 2 in the plasma and catecholanin and its by-products should be checked (24-hour urine samples). In cases of serious hypertension hormone therapy should be discontinued at once. Primary aldosteronism and renal artery stenosis must be excluded in the differential diagnosis, for although these hypertensive disorders exhibit similar biochemical changes, they should be treated by surgical intervention. Usually hypertension is reversible after cessation of therapy with contraceptive steroids. However, some cases of irreversible hypertention, kidney failure, and malignant nephrosclerosis have been described. Hypertensive somen who wish to use oral contraceptives may, under medical supervision try a modified hormonal contraceptive (minipill without estrogen) or sequential or lower dosages.
 ...
PMID:[Clinical aspects of hypertension under contraceptive steroids]. 79 66


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