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

A method is described, which is suitable to collect continuously and quantitatively saliva from both parotid glands in rats under in vivo conditions and which allows to investigate salivary electrolyte composition in relation to flow rate during several hours. This might be of expanding scientific interest in disturbances of transepithelial electrolyte transport in various pathophysiological situations (for instance different forms of experimental hypertension, endstage renal failure and so on).
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PMID:Technique of continuous collection of parotid saliva in the rat. 66 11

Study of case-notes and autopsy reports of patients with renal disease suggests that analgesic nephropathy is responsible for at least 12 per cent of cases of chronic renal failure, Between 1970 and 1975 eight new cases of analgesic nephropathy were seen annually in a population of three-quarters of a million. This is equivalent to an incidence of 490 new cases per year in England and Wales. Fifty-five patients with analgesic nephropathy were followed from one to 84 months for a total of 190 patient years. Changes in renal function were correlated with bacteriuria, hypertension and analgesic consumption. One-third of the cases had been misdiagnosed and analgesic abuse was only revealed by thorough examination of case-notes and autopsy records, together with careful questioning of patients and relatives. A number of cases had been classified as chronic pyelonephritis. The calculated survival rate at five years was 44 per cent. Mortality was related to the level of analgesic consumption and the degree of renal failure at the time of diagnosis. The prognosis was poor if serum creatinine at presentation was greater than 400 mumol/l. There was no significant correlation between deterioration in renal function and bacteriuria or hypertension. Forty-two per cent of the patients were taking analgesics for arthritis; 27 per cent had rheumatoid arthritis. Most had been taking large quantities of analgesic mixtures containing phenacetin. Renal papillary necrosis was present in only 26 per cent on intravenous urography but was found in all those examined at autopsy. Twenty thousand, two hundred and twenty-nine autopsy reports were examined for the presence of renal disease. Renal papillary necrosis was found in 0.41 per cent, and could be attributed to analgesic nephropathy in 24 per cent. In patients under 65 years of age analgesic nephropathy appeared to be a more frequent cause of death than chronic pyelonephritis. The report indicates the need for careful enquiry about analgesic consumption in all patients with renal disease, and emphasizes the importance of early diagnosis and cessation of analgesics in suspected cases of analgesic nephropathy.
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PMID:Analgesic nephropathy: an important cause of chronic renal failure. 67 50

Hypokalemia is an uncommon cause of rhabdomyolysis with acute tubular necrosis. We recently treated a patient in whom severe hypokalemia attributed to diuretic therapy antedated acute myoglobinuric renal failure by six months. After recovery, hypokalemia persisted and subsequent evaluation disclosed primary aldosteronism. This case is a unique presentation for primary aldosteronism and illustrates the importance of diagnosis before treatment in hypertension as well as the hazards of hypokalemia.
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PMID:Primary aldosteronism presenting as myoglobinuric acute renal failure. 68 40

Chronic atrophic pyelonephritis is associated with vesicoureteric reflux in infancy. Reflux disappears during childhood in 50% of cases. It is more commonly detected in infants (49%) and children (26%) with infection than in adults (4.4%). Severe reflux may persist in adults and is usually (94%) associated with scarring. Patients with end-stage renal failure due to pyelonephritis are much younger than patients with end-stage renal failure due to other causes. The incidence of reflux according to sex is equal in infancy, but after infancy both pyelonephritic scarring and reflux are far more common in females. Infection is the likely cause of progressive scarring in females. Hypertension is associated with chronic atrophic pyelonephritis. Proteinuria is the worst prognostic feature in patients with reflux nephropathy and pyelonephritic scarring. Intrarenal reflux determines the site of scarring. The role of surgical correction of vesicoureteric reflux remains uncertain, but meticulous control of infection appears to prevent progressive scarring.
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PMID:Reflux nephropathy and chronic atrophic pyelonephritis: a review. 73 56

A retrospective study of 32 adult patients undergoing ureteric reimplantation for reflux has been carried out. Reflux and reimplantation in relation to urolithiasis, pregnancy, renal failure, hypertension and bladder neck obstruction have been discussed. Eighty-four per cent of patients with primary reflux had pyelonephritic scarring compared with only 34% of patients where reflux was secondary. Reimplantation has been technically successful in preventing reflux in every patient in this series, with 18 patients (65%) becoming symptom free. Pyelonephritis, hypertension and renal failure were not significantly improved but no progressive changes were observed in the follow-up period after reimplantation.
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PMID:Ureteric reimplantation for vesico-ureteric reflux in the adult. 75 67

The heat precipitation method (Aberdeen method) was compared with the Ratnoff and Menzie method of fibrinogen assay in 320 donors, including normals and patients suffering from malignant melanoma, renal failure, hypertension, multiple myeloma, etc. Excellent correlation (r=0-8287, p less than 0-000 000 1) was found between these two methods. However, on some occasions individual low results were obtained by the Aberdeen method in the presence of cryoglobulins or excessively high plasma viscosity. The latter effect was tested also by additions of albumin, glucose, and dextrans.
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PMID:Re-evaluation of heat precipitation method for plasma fibrinogen estimation: effect of abnormal proteins and plasma viscosity. 77 32

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.
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PMID:Hypertension after renal transplantation. 77 38

During a six year period twelve patients with insulin dependent diabetes and end-stage renal failure received cadaveric kidney grafts. Eleven of the patients have previous to this been hemodialysed, one patient was transplanted before hemodialysis was necessary. The cumulative two year survival was thirty-seven per cent for the patients, and twenty-nine per cent for the kidney grafts. The average time of observation was eleven months, the motality was fifty per cent. The causes of death were acute myocardial infarction in two cases, sepsis in two cases, severe hypoglycemia in one case and unexpected sudden death in one case. The most prominent problems in the treatment of the diabetic patients after the renal transplantation were difficulties in the regulation of the diabetes, rejections, infections, cardiac failure and aggravation in pre-existing hypertension.
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PMID:Renal transplantation in patients with insulin requiring diabetes and renal failure. 78 7

The application and use of radio-isotopes in nephrology have been neglected by clinicians. The indications and techniques used in the renogram and renal scan in the light of our experience over 2 1/2 years are presented. Although these methods are finding ever-increasing applications, the main uses at this stage are the investigation of possible renovascular hypertension, acute obstructive renal failure and postrenal transplant complications.
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PMID:Renography using the gamma camera and the intertechnique cinescintigraphy system. A review of the current applications. 78 71

The hepatorenal syndrome is defined as the spontaneous onset of progressive renal failure in patients with far advanced hepatic disease, usually on the basis of cirrhosis. The clinical characteristics of the syndrome include azotemia, oliguria, hyponatremia, low urinary sodium excretion and the absence of abnormal findings in the urinary sediment. Although the results of a large number of studies suggest that abnormal histologic features in the kidneys are infrequent, changes such as glomerulosclerosis, degeneration of tubular cells and alterations in the basement membranes have been described. Theories on the pathophysiologic aspects of the syndrome, including reduced plasma volume, inferior vena cava hypertension and active renal vasoconstriction, are presented. The last of these is currently the most widely accepted theory in which there is a selective redistribution of blood flow away from the cortical nephrons to the medullary nephrons on the basis of selective cortical vasoconstriction. The role of the synpathetic nervous system, as well as that of plasma renins in the cause of this condition is explored. Therapy for the hepatorenal syndrome generally has failed to ameliorate extremely unfavorable mortality rates. Such factors as the effects of plasma volume expansion; various pharmacologic agents, including dopamine, Octopressin and metaraminol; portacaval shunt; transplantation of the liver, and steroids are discussed. Regardless of specific therapy, the few patients who do survive tend to demonstrate a significant reversible component with respect to hepatic disease.
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PMID:The hepatorenal syndrome. 78 80


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