Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a series of 755 renal biopsies atheromatous emboli were found in biopsies of 8 men from 49 to 72 years of age. Unexplained recent deterioration of renal function was present in each. This previously unreported incidence of 8/755 biopsies is ascribed to the selection for biopsy of patients with unexplained decrease in renal function. Hypertension was a major feature in 6, hyperlipidemia in 2, a leaking aortic aneurysm in 1, carcinoma of the pancreas in 1, and chronic glomerulonephritis in 1 patient. Toluidine-blue-stained epoxy sections proved to be more effective in recognizing small emboli than paraffin sections. Ultrastructural observation concerned a) early lesions (eg, fresh emboli with endothelial distortion or injury), b) intermediate lesions (eg, histiocytic or giant cell reaction and intimal proliferation), and c) later lesions (eg, extraluminalization of the crystals eventually resulting in inert location in intimal stroma). Osmiophilic deposits on the crystal surfaces were myelin-form in structure and were felt to result from lysosomal action.
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PMID:Atheromatous emboli in renal biopsies. An ultrastructural study. 111 20

The prognosis of chronic glomerulonephritis based on renal function was assessed using a statistical technique of the Markov process, where the absorbing state was assumed to be an uremic state, 194 adult patients with different types of disease were subjected to study. The 15 min value obtained in the intravenous PSP excretion test was divided into five states; SI (greater than 34%, normal), SII(25-34), SIII(15-24), SIV(5-14) and SV (greater than 5, uremic). The rates of SV with time were calculated with respect to several clinical characteristics. The prognosis of the patients with hypertension, distinct proteinuria and hematuria, or cellular cylindruria appeared to be relatively poor. The estimated number of years from each state to SV were also calculated. The results were similar to those already reported and gave us more exact information about the prognosis.
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PMID:Prognosis of chronic glomerulonephritis in adult patients estimated on the basis of the Markov process. 112 60

Basic haemodynamic parameters were measured in 58 men in various stages of essential hypertension, 18 patients with hypertensive form of chronic glomerulonephritis, and 23 practically healthy persons during graded exercise in the supine position on a bicycle ergometer for 30 minutes. During exercise, the systolic pressure rose in all persons investigated, whereas the diastolic pressure markedly increased only in patients with arterial hypertension. The cardiac index increased, according to the intensity of the exercise equally in the healthy persons and in patients in early stages of essential hypertension; a lesser increase in the cardiac index was observed in patients in late stages of hypertension and in those with chronic glomerulonephritis. The increase in the cardiac index during exercise is essentially due to an increase in the heart rate; the stroke index increases only slightly, and in later stages of essential hypertension even decreases. The total peripheral resistance diminishes during exercise, but less so in patients with arterial hypertension in whom it is distinctly higher than in healthy persons. The circulating blood volume decreases during exercise in consequence of a decrease in plasma volume, whereas the haematocrit value increases. Renal blood flow and glomerular filtration decrease during exercise, both in healthy untrained persons and in patients with arterial hypertension. In patients in late stages of essential hypertension and in those with glomerulonephritis, the above parameters decrease more markedly and at lower exercise intensity than in healthy persons.
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PMID:Changes in general haemodynamics and renal function during exercise in patients with arterial hypertension. 114 56

The difference of the prognosis between essential and renal hypertension (chronic glomerulonephritis) was examined by compairing the survival rate of the patients, and the effect of lability of blood pressure and the effect of the response to hypotensive drugs on the prognosis of the two types of hypertension was observed. The prognosis of renal hypertensives was remarkedly worse when it was compaired with the prognosis of essential hypertensives. More then 80% of the latter was still alive after ten years, while the mortality rate of the former after 5 years was only 20%. Each factor of severity (diastolic pressure, optic fundi, cardiac, cerebrovascular and renal complication) in non severe patients (group O-II) did not differently affect the survival rate of both hypertensives. Diverse prognosis was observed in severe patients (group III-IV), depending on each factor of severity. In renal hypertension the survival rate was extremely low when the patients had high diastolic pressure, severe cardiac and cerebrovascular complication. It was not so low in the patients with severe ophthalmoscopic change. The prognosis of essential hypertension was poor in the order of severe cerebrovascular complication, renal complication and cardiac complication. The survival rate of the patients with high diastolic pressure or severe ophthalmoscopic change was considerably high. The patients with both renal and essential hypertension showed greater survival rate when the blood pressure was much more reduced by bed rest or antihypertensive drugs during the first hospitalization.
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PMID:Comparison of the prognosis of hypertension associated with chronic glomerulonephritis with that of essential hypertension. 115 38

Incidence of hypertension in chronic glomerulonephritis and its influence on the clinical course of the disease were studied using statistic technique, especially that of Markovian process. 1. Incidence of hypertension in a total of 283 cases was 15.2%, while in the patients of which renal function reduced to approximately one half of the normal was about 50%. 2. The average of blood pressure in this disease tends to elevate with the decrease in 15 minute value of PSP excretion test and with the increasing serum creatinine level, although the variations are large. 3. After a fall of renal function to approximately one-third of the normal, the rate of clinical course is markedly rapid. 4. The prognosis of the progressive type of chronic glomerulonephritis is obviously affected to be shorten by the presence of hypertension. 5. According to the results obtained by the Markovian approach, survival years of the patients with wide range of renal function can be predicted with relative accuracy.
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PMID:Prognosis of chronic glomerulonephritis with special reference to hypertension and renal function. 115 42

In 45 patients with chronic compensated hypertensive glomerulonephritis and in 184 others suffering from different clinical variants of the same disease the state of tubular functions controlling the osmotic and acid-base homeostasis was investigated. The objective was to assess in this connection the scope of renal processes in this connection the scope of renal processes peculiar to the hypertensive from that keep up these function, to reveal (by studying the materials of renal biopsies) the morphological substrate of the dysfunctional under consideration and also to determine its ossible importance in maintaining hypertension. As a criterion for the mass of active nephrons the magnitude of glomerular filtration (from clearance of endogenous creatinine with a minute-long diuresis of 1.5-2.5 ml/min) was used. It was established that, as distinct from the latent forms, in cases of benign hypertensive form of chronic glomerulonephritis, as well as in those of nephritic one, the ammonium excretion is halved and so is also the maximum osmotic concentration. Common to the hypertonic syndrome proved to be a particularly steep, by 70%, fall of CH2O. The disclosed disturbances, except for reduced excretion of "osmotically free" water, may be attributed to the nature of morphological changes inherent in this form of the disease, i.e. in the atrophy of the tubular epithelium and of the tubulo-interstitial component. The major fall of CH2O is largely determined by an increased proximal transport of sodium and inhibition of this process in the distal part of the nephron. A derangement of the studied tubular functions may, though in part, be considered as a factor keeping up the arterial pressure.
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PMID:[Tubular functions in the regulation of osmotic and acid-base homeostasis in chronic hypertensive compensated glomerulonephritis]. 123 22

ACE inhibitors which till recently were used only in the treatment of cardiovascular diseases are becoming a perspective group of drugs also in the treatment of chronic nephropathies. It was revealed that they are effective in particular in the treatment of proteinuria of different etiology and have also a marked renoprotective effect and are therefore recommended to slow down the progression of renal failure. They reduce intraglomerular hypertension, increase glomerular filtration and the renal blood flow, and it is assumed that they can retard the progression of chronic glomerulonephritis and diabetic nephropathy. It may be excepted that their therapeutic application will in the near future be extended also to clinical nephrology.
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PMID:[ACE inhibitors--a prospective new group of drugs for the treatment of kidney diseases]. 129 14

The major target organs that become damaged as a consequence of long-standing arterial hypertension are the kidneys, heart, and brain. Left ventricular hypertrophy (LVH) cannot be considered only as an adaptive process to elevated blood pressure (BP), and the heart is also a major target organ in malignant arterial hypertension (MH). Magnetic resonance (MR) was used as a method for visualization of the heart in 68 patients with MH including 18 with essential hypertension, 16 with chronic glomerulonephritis, 13 with chronic pyelonephritis, 16 with renovascular hypertension, eight with adrenal tumors, and in 20 healthy volunteers (as a comparison group). Electrocardiogram-gated, double spin-echo magnetic resonance imaging was performed to image the right and left ventricles (RV and LV), interventricular septum, apex and LV posterior wall, left atrium, and aortic root. In all the patients, symmetric LV hypertrophy was registered and in the most severe cases LV wall thickness was more than 20 mm. There was no LV cavity enlargement or local contractility abnormalities. There was close correlation of LVH and diastolic BP. The degree of LVH and diastolic dimensions of the LV differed between etiologies of MH. These findings show that different pathophysiologic mechanisms of development of MH influence the processes of myocardial hypertrophy. The highly informative yield of MR tomography for evaluating structural and functional changes of the heart under MH must be underlined.
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PMID:Magnetic resonance imaging of cardiac hypertrophy in malignant arterial hypertension. 138 64

The incidence of end-stage renal disease is increasing and this results in an enhanced requirement of renal replacement therapy facilities. This brings about a significant burden on health care budgets and makes strategies that slow down or even prevent deterioration of the renal function mandatory. Although large scale randomized, controlled and prospective clinical trials on the effect of blood pressure control on the course of renal function are lacking, there is circumstantial evidence from animal, epidemiological and clinical studies to state that treatment of hypertension to blood pressure values well within the normal range is most important to ameliorate the downhill course of renal function in patients with chronic renal failure. Moreover, treatment of hypertension is critical to reduce morbidity and mortality of cardiovascular disease in these patients, who have an increased risk for such events. Low-protein diets, if possible with ketoacid supplement, are advocated to slow down the deterioration of renal function. However, based on the results of recent studies, low-protein diets may only have a moderate effect in patients with diabetic nephropathy and, possibly, in patients with chronic glomerulonephritis. The possibility of influencing renal ammoniagenesis by protein restriction or calcium carbonate administration, and an attenuation of alternative complement pathway activation and tubulo-interstitial injury, are challenging. Finally, in animal studies it has been found that abnormalities in serum lipid profile contribute to the progression of chronic renal failure, which may be prevented by pharmacological treatment of hyperlipidemia. Studies in humans concerning this subject are lacking at this moment, but treatment of hyperlipidemia is proper to reduce cardiovascular events.
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PMID:Clinical strategies for arresting progression of renal disease. 140 61

Renal function was serially investigated during the development of hypertension in a 12.8-year-old girl with chronic glomerulonephritis. Clearances of inulin (CIn) and para-aminohippuric acid (CPAH), filtration fraction, and sodium excretion were measured during hydropenia and isotonic saline volume expansion. Blood pressure was initially labile, but after a few years fixed hypertension developed, and antihypertensive treatment with propranolol was started. During the early stages of hypertension, the filtration fraction during hydropenia was reduced, but the natriuresis during volume expansion was normal. When the hypertension was fixed, glomerular filtration rate, CPAH, and filtration fraction were normal, but the natriuresis was exaggerated. Antihypertensive treatment only partially corrected the natriuresis.
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PMID:Changes in renal function during the development of hypertension and effects of antihypertensive treatment. A case report. 143 10


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