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

Six infants with hydronephrosis developed hypertension during the first year of life. Five of them, all with proved or suspected acute urinary tract infection, had transient hypertensive episodes lasting for 7 to 17 days. One of the five infants, who had ureteropelvic junction obstruction and unilateral hydronephrosis, remained normotensive after nephrectomy. The sixth patient, with bilateral hydronephrosis and elevated peripheral vein renin activity, has had persistent hypertension. We discuss possible mechanisms underlying hypertension in these infants and suggest that young patients with hydronephrosis may be unusually predisposed to acute hypertensive episodes.
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PMID:Arterial hypertension in infants with hydronephrosis. Report of six cases. 83 20

Urine of 198 diabetics and 147 non-diabetics was examined for bacteriuria by means of the Uricult dip slide method. Prevalence of bacteriuria in diabetics (18,7%) was significantly higher than in the control group (7,6%). This increased prevalence in diabetics was due primarily to an exceedingly high prevalence in diabetic women (27%). There was no relation between bacteriuria and age, duration of diabetes, treatment for diabetes, quality of control of diabetes, symptoms of urinary tract infection or hypertension.
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PMID:Bacteriuria in Black diabetics. 84 59

A series of 262 children suffering from vesico-ureteric reflux is presented. Nearly all presented with a urinary tract infection and the age at onset of symptoms was predominantly in the pre-school years. The reflux was not diagnosed in the majority until after the children started attending school. Over one-third had symptoms for more than half their lives before reflux was diagnosed. The incidence of hypertension and renal insufficiency in the series were 4% and 7-8% respectively. Nearly 60% of the children were selected by defined criteria for operation as their initial treatment. The remainder were treated conservatively in the first instance but 30% of these subsequently required operation. Reflux was eliminated in 96.3% of the children at the first operation and 5.5% developed postoperative ureteric dilatation, none of them permanently. Reflux disappeared spontaneously in two-thirds of the children treated conservatively but took more than 3 years in 46%. Infection recurred in 24% of children treated by operation and in 29% treated conservatively. The incidence with which reflux disappeared spontaneously in the children treated conservatively was related to time, not to the infection recurrence rate.
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PMID:The management of ureteric reflux in children. 87 Jan 34

The symptoms and clinical course of chronic hypokalemic nephropathy are described in 21 patients with longstanding potassium deficiency. In 14 patients (group A) the potassium depletion was caused by malnutrition and/or abuse of laxatives and/or diuretics. 7 patients (group B) suffered from primary (6 cases) or secondary (1 case) aldosteronism. The average duration of potassium depletion was 8.8 years in group A and 3.4 years in group B. Depending on the duration of potassium depletion, chronic renal disease develops which may end in terminal renal failure. Urinalysis is non-specific or negative. The clearance of creatinine slowly decreases. Metabolic alkalosis is a constant finding and in group A occurs with a tendency to hyponatremia and hypochloremia, with the development of metabolic acidosis only in advanced renal insufficiency. In contrast to patients of group B, patients of group A have normal or low blood pressures converting to hypertension, if at all only in the late phase. The cases of group A had secondary aldosteronism (and, correspondingly, a hyperplastic juxtaglomerular apparatus). Although urinary tract infection is a regular finding in advanced stages, the clinical, radiological and histological evidence suggests that bacterial pyelonephritis, if occurring at all, is rather a complication than the cause of the disease. In 5 patients 7 instances of acute renal failure of unknown origin were observed which was lethal in one case. Another patient died from terminal renal failure, a third from an intercurrent pneumonia. Renal histology obtained from 13 patients showed the picture of diffuse chronic abacterial interstitial nephritis.
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PMID:Symptoms and course of chronic hypokalemic nephropathy in man. 87 Feb 67

Analgesic-induced renal disease occurs more commonly than is recognized; unless specific inquiry is made, it is seldom diagnosed. Patients with chronic pain, especially those with hypertension, urinary tract infection, or renal insufficiency, should be suspect. The condition is preventable and even in the late stages is manageable if recognized. Analgesic abuse may result in end-stage renal disease; it accounts for a significant percentage of patients entering chronic hemodialysis or renal transplant programs.
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PMID:Analgesic nephropathy--a continuing problem. 99 79

Radiological findings of segmental renal hypoplasia are reported, based on the observation of 6 children aged between 8 and 14. The leading clinical symptom is arterial hypertension. Urinary tract infection and proteinuria are additional common findings. Cases with bilateral disease often have renal failure. The intravenous urogram shows unilateral or bilateral small kidneys with segmental renal scarring and transverse lobulation. In the pathological areas the calyces are ectatic or clubbed and their infundibulum is elongated. Vesico-ureteral reflux is frequent. In angiography the lobulated segments appear hypovascular. Diagnosis was verified by histological examination.
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PMID:Segmental renal hypoplasia in childhood. 101 4

A long-term study of 17 patients with paroxysmal nocturnal hemoglobinuria revealed an unexpectedly high incidence of functional and anatomic renal abormalities. All patients demonstrated varying degrees of hematuria and proteinuria distinct from hemoglobinuria. All patients also had granular casts in multiple urinalyses. Evaluation of renal function revealed hyposthenuria, abnormal tubular function and declining creatinine clearance. Radiologically, one or more of these demonstrated enlarged kidneys, renal cortical infarcts and thinning, papillary necrosis, acute renal atrophy, retroperitoneal hematoma and ureteral infarction, which were confirmed by autopsy studies. Hypertension developed in 7 patients. Urinary tract infection was uncommon and no patient had a clinical history compatible with chronic or acute pyelonephritis. Contrary to usual opinion our compatible clearly showed evidence of frequent and widespread renal pathology in paroxysmal nocturnal hemoglobinuria most likely due to repeated microvascular thromboses similar to the venous trombosis involving other organs in this disorder. Since most of these patients present initially to urologists knowledge of this entity is mandatory.
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PMID:Urologic manifestations of paroxysmal nocturnal hemoglobinuria. 114 29

There are now laboratory means of screening and identifying people who, although they are free from the signs of urinary tract infection, fit into abnormal groups owing to the high numbers of bacteria and leukocytes in their urine. Chronic bacteriuria and pathologic pyuria, with or without symptoms, have important physiologic and pathologic consequences. It is the physicians opportunity to recognize and treat these asymptomatic as well as symtomatic urinary tract infections. If untreated and uncorrected the result, with progressive frequency over a period of 10-15 years, is increased morbidity, especially with pregnancies, structural damage to the kidneys, kidney stones, uremia, hypertension, and premature death.
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PMID:Diagnosis and importance of asymptomatic bacteriuria in adults. 122 9

A retrospective study of 1989 records of 10,594 pregnant women registered at 47 primary health care (PHC) centers in Al-Hassa, Saudi Arabia, aimed to evaluate the performance of their prenatal care services and to gather baseline data to conduct future evaluations. These women represented 58% of pregnant women in Al-Hassa in 1989. The other pregnant women may have received prenatal care at medical facilities of the Arabian American Oil Company (ARAMCO), the National Guard, or the private sector. 53.1% of the registered women had made more than 5 prenatal care visits. 66.7% and 40.3% of all registered women received the first and second dose of tetanus toxoid, respectively. PHC center staff identified 46.2% of women as having high-risk pregnancies, but they only referred 17.5% of these women to King Fahad Hofuf Hospital for obstetric consultation. However, at least 6 major PHC centers had an obstetrician on staff. Causes in reproductive history were responsible for classifying 67.4% of the high-risk pregnancies. These causes included grandmultiparity (65%), abortion (12%; 8.3% - 2 abortions), previous Cesarean section (5.8%), RH negative (4.8%), young primipara (4.5%), and other causes, including history of preeclampsia, neonatal death, congenital anomalies, and low birth weight. Associated medical conditions made up the next highest class of high-risk pregnancies (25.4%). These conditions were sickle cell anemia (69.7%), diabetes (17.1%), hypertension (10.4%), and other causes (e.g., chronic bronchitis). Causes in current pregnancy comprised 7.2% of high-risk pregnancies and included non-sickle cell anemia (34.6%), bleeding (12%), malpresentation (17%), twins (14%), urinary tract infection (7%), and other causes (e.g., ectopic pregnancy). 67.7% of women with high-risk pregnancies delivered at King Fahad Hofuf Hospital, 28.8% at PHC centers, 7.1% at medical services of ARAMCO, and 2.4% outside of Al-Hassa area. 94% and 0.8% of high-risk pregnancy cases had unassisted and assisted vaginal births, respectively. The remaining cases delivered by Cesarean section.
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PMID:Prenatal care in primary health care centers of Al Hassa, Saudi Arabia. 129 49

A total of 132 infants and children with grades III and IV primary vesicoureteral reflux was entered into a prospective trial comparing medical to surgical management. Inclusion criteria were an age not exceeding 10 years and a glomerular filtration rate of at least 70 ml. per minute per 1.73 m.2. Children with significant urinary tract malformations and clinical signs/symptoms of dysfunctional voiding were not accepted into the trial. Medical therapy consisted of continuous low dose antibiotic prophylaxis until vesicoureteral reflux resolved. The type of surgical procedure used for the correction of reflux was left to the discretion of the surgeon. Outcome variables included the appearance or progression of renal lesions, rate of renal growth, recurrence rate of urinary tract infection or pyelonephritis, changes in total kidney glomerular filtration rate, development of hypertension and resolution rate of vesicoureteral reflux. Followup at 6, 18, 36 and 54 months after entry included, in addition to history and physical examination, voiding cystourethrography, excretory urography and a urine culture. Of the patients 68 were allocated to the medical group and 64 to the surgical group. They were stratified for age, sex and preexisting renal scarring. Of the patients 10% were boys, 47% were between 2 and 6 years old at entry, 93% had a history of pyelonephritis, 67% had either scarring or thinning of the parenchyma at entry, 87% had grade IV vesicoureteral reflux in at least 1 unit and 56% had bilateral reflux. There were no significant differences in the frequency distribution of entry characteristics between the patients allocated to either group. New renal scarring developed in 22% of medical and 31% of surgical patients (p < 0.4). Growth of kidneys with grade IV vesicoureteral reflux was slightly less than normal in the medical (-0.67 +/- 0.15 standard deviation) and surgical (-0.42 +/- 0.11 standard deviation) groups (p < 0.7). Pyelonephritis occurred in 15 medical patients versus 5 surgical patients (p < 0.05). There was no significant change in glomerular filtration rate within each treatment group and no difference in glomerular filtration rate between groups. No patient had hypertension during the followup period. The disappearance rate of vesicoureteral reflux in patients with grade IV reflux was approximately 8% per year. Of the medical patients 75% still had vesicoureteral reflux after 3 years of observation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Results of a randomized clinical trial of medical versus surgical management of infants and children with grades III and IV primary vesicoureteral reflux (United States). The International Reflux Study in Children. 143 85


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